Individual provider Active NPI

Todd David Hirsch, ATC

  • Athletic Trainer
  • Berkeley Heights, NJ
National Provider Identifier
1730148420
Registry record updated Jul 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
25MT00139800 Issued in NJ
Practice address
175 Watchung Blvd
Berkeley Heights, NJ 07922-2726
Phone
(908) 464-3100
NPI assigned
Mar 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 67 000767 NY
Athletic Trainer 2255A2300X 25MT00139800 NJ Primary

Addresses

Primary practice location

175 Watchung Blvd
Berkeley Heights, NJ 07922-2726

Mailing address

220 Oakridge Rd
Hillsdale, NJ 07642-1912

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
25MT00139800NJMDAthletic Trainer
67 000767NYMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1142899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405728000000",
    "number": "1730148420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 OAKRIDGE RD",
            "city": "HILLSDALE",
            "state": "NJ",
            "postal_code": "076421912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 WATCHUNG BLVD",
            "city": "BERKELEY HEIGHTS",
            "state": "NJ",
            "postal_code": "079222726",
            "telephone_number": "908-464-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIRSCH",
        "first_name": "TODD",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-21",
        "last_updated": "2014-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NY",
            "license": "67 000767",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NJ",
            "license": "25MT00139800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley Heights, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.