Organization Active NPI

Endocrine and Diabetes PA

  • Endocrinology, Diabetes & Metabolism Physician
  • Livingston, NJ
National Provider Identifier
1750400800
Registry record updated Jul 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
Legal business name
ENDOCRINE AND DIABETES PA
Practice address
200 S Orange Ave
Suite 219
Livingston, NJ 07039-5817
Phone
(973) 322-7200
NPI assigned
Mar 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2009

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

Authorized official

Name
Dr. Samuel Dower, MDNPI 1942260690
Title
Partner
Phone
(973) 322-7200

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
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RE0101X Primary

Addresses

Primary practice location

200 S Orange Ave
Suite 219
Livingston, NJ 07039-5817

Mailing address

200 S Orange Ave
Suite 219
Livingston, NJ 07039-5817
Phone (973) 322-7200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051024000912 NJ Part B Supplier - Clinic/Group Practice 0042237539 Receives reassigned benefits from 3 practitioners
Practice locations: Livingston, NJ

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
31D0925734Endocrine & Diabetes PA200 South Orange Ave, Livingston, NJ 07039AccreditationJun 15, 2027

National Provider Directory

National Provider Directory

Locations

200 S Orange Ave
Ste 219
Livingston, NJ 07039
Phone (973) 322-7200

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248739200000",
    "number": "1750400800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 S ORANGE AVE",
            "address_2": "SUITE 219",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070395817",
            "telephone_number": "973-322-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S ORANGE AVE",
            "address_2": "SUITE 219",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070395817",
            "telephone_number": "973-322-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENDOCRINE AND DIABETES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-28",
        "last_updated": "2009-07-28",
        "status": "A",
        "authorized_official_last_name": "DOWER",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "973-322-7200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livingston, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.