NPIMap

Organization Active NPI

Premier Brain and Spine LLC

  • Durable Medical Equipment & Medical Supplies
  • Lakewood, NJ
National Provider Identifier
1720968464
Registry record updated Sep 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
PREMIER BRAIN AND SPINE LLC
Practice address
1215 Route 70 Ste 1001
Lakewood, NJ 08701-6958
Phone
(732) 584-2400
Fax
(848) 305-6003
NPI assigned
Sep 4, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2025

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

Authorized official

Name
Dr. Eric D Freeman
Title
Part-Owner; Managing Member
Phone
(732) 906-9600

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0000X
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

1215 Route 70 Ste 1001
Lakewood, NJ 08701-6958

Mailing address

90 Matawan Rd Ste 302
Matawan, NJ 07747-2653
Phone (732) 441-7177

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260217002387 NJ DME Supplier - Multi-Specialty - Physician 6608264833 Practice locations: Lakewood, NJ

National Provider Directory

National Provider Directory
Tax ID family
Premier Brain and Spine LLC35 organizations share this tax ID, including this one

Other organizations with this tax ID 34

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

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1756944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756944000000",
    "number": "1720968464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 MATAWAN RD STE 302",
            "city": "MATAWAN",
            "state": "NJ",
            "postal_code": "077472653",
            "telephone_number": "732-441-7177",
            "fax_number": "732-441-7165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 ROUTE 70 STE 1001",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087016958",
            "telephone_number": "732-584-2400",
            "fax_number": "848-305-6003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER BRAIN AND SPINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-04",
        "last_updated": "2025-09-04",
        "certification_date": "2025-09-04",
        "status": "A",
        "authorized_official_last_name": "FREEMAN",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PART-OWNER; MANAGING MEMBER",
        "authorized_official_telephone_number": "732-906-9600",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2025; 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.