NPIMap

Organization Active NPI

Rutgers Health-RWJ Scleroderma Program

  • Endocrinology, Diabetes & Metabolism Physician
  • New Brunswick, NJ
National Provider Identifier
1720113616
Registry record updated Jan 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
Legal business name
RUTGERS HEALTH-RWJ SCLERODERMA PROGRAM
Practice address
125 Paterson St
Suite 5100a
New Brunswick, NJ 08901-1962
Phone
(732) 235-7219
Fax
(732) 235-7224
NPI assigned
Feb 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Brenda Lawrence
Title
Director of Revenue Cycle
Phone
(732) 235-6070

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RE0101X Primary

Addresses

Primary practice location

125 Paterson St
Suite 5100a
New Brunswick, NJ 08901-1962

Mailing address

66 W Gilbert St
Red Bank, NJ 07701
Phone (732) 212-0051

Other names 1

  • Rutgers Health-RWJ Endocrinology Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050502000326 NJ Part B Supplier - Clinic/Group Practice 5193764991 Receives reassigned benefits from 667 practitioners
38 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: New Brunswick, NJ; North Brunswick, NJ; Perth Amboy, NJ; Piscataway, NJ; Somerset, NJ; Somerville, NJ; Toms River, NJ; East Brunswick, NJ…

Other NPIs on the same Medicare enrollment 38

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 38

National Provider Directory

National Provider Directory
Tax ID family
Rutgers Health - RWJ Clinical Genetics27 organizations share this tax ID, including this one

Other organizations with this tax ID 26

Organizations that report the same tax identification number in the National Provider Directory.

View all 26

Locations

125 Paterson St
#5100
New Brunswick, NJ 08901
Phone (732) 235-6512

125 Paterson St
Ste 5100A
New Brunswick, NJ 08901
Phone (609) 655-5175

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 18

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610928000000",
    "number": "1720113616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 W GILBERT ST",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "07701",
            "telephone_number": "732-212-0051",
            "fax_number": "732-212-0713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 PATERSON ST",
            "address_2": "SUITE 5100A",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089011962",
            "telephone_number": "732-235-7219",
            "fax_number": "732-235-7224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUTGERS HEALTH-RWJ SCLERODERMA PROGRAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2021-01-18",
        "certification_date": "2021-01-18",
        "status": "A",
        "authorized_official_last_name": "LAWRENCE",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_title_or_position": "DIRECTOR OF REVENUE CYCLE",
        "authorized_official_telephone_number": "732-235-6070"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rutgers Health-RWJ Endocrinology",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in New Brunswick, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.