NPIMap

Organization Active NPI

SM Trinity Primary Care LLC

  • Primary Care Nurse Practitioner
  • S Plainfield, NJ
National Provider Identifier
1740055714
Registry record updated Nov 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
Legal business name
SM TRINITY PRIMARY CARE LLC
Practice address
904 Oak Tree Ave Ste F
S Plainfield, NJ 07080-5126
Phone
(732) 672-3140
NPI assigned
Nov 20, 2023
Last updated
Nov 20, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2023

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

Authorized official

Name
Susan OmoregieNPI 1578926697
Title
Director
Phone
(732) 672-3140

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X Primary

Addresses

Primary practice location

904 Oak Tree Ave Ste F
S Plainfield, NJ 07080-5126

Mailing address

904 Oak Tree Ave Ste F
S Plainfield, NJ 07080-5126
Phone (732) 672-3140

Other practice location 1

904 Oak Tree Ave Ste F
S Plainfield, NJ 07080-5126
Phone (732) 672-3140

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240418000487 NJ Part B Supplier - Clinic/Group Practice 2769821156 Receives reassigned benefits from 3 practitioners
Practice locations: Edison, NJ

National Provider Directory

National Provider Directory

Locations

904 Oak Tree Ave
Ste F
South Plainfield, NJ 07080
Phone (732) 672-3140

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1700438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700438400000",
    "number": "1740055714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 OAK TREE AVE STE F",
            "city": "S PLAINFIELD",
            "state": "NJ",
            "postal_code": "070805126",
            "telephone_number": "732-672-3140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 OAK TREE AVE STE F",
            "city": "S PLAINFIELD",
            "state": "NJ",
            "postal_code": "070805126",
            "telephone_number": "732-672-3140"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "904 Oak Tree Ave Ste F",
            "address_purpose": "LOCATION",
            "city": "S Plainfield",
            "state": "NJ",
            "postal_code": "070805126",
            "country_code": "US",
            "telephone_number": "732-672-3140",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SM TRINITY PRIMARY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-20",
        "last_updated": "2023-11-20",
        "certification_date": "2023-11-20",
        "status": "A",
        "authorized_official_last_name": "OMOREGIE",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "732-672-3140"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in S Plainfield, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2023; 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.