Individual provider Active NPI

Steven P Fries, PA-C

  • Physician Assistant
  • Princeton, NJ
National Provider Identifier
1770518607
Registry record updated Oct 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00497900 Issued in NJ
Practice address
325 Princeton Ave
Princeton, NJ 08540-1617
Phone
(609) 924-8131
Fax
(609) 924-8532
NPI assigned
Jul 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 000557 CT
Physician Assistant 363A00000X 25MP00497900 NJ Primary

Addresses

Primary practice location

325 Princeton Ave
Princeton, NJ 08540-1617

Mailing address

325 Princeton Ave
Princeton, NJ 08540-1617
Phone (609) 924-8131

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181129003271 NJ Practitioner - Physician Assistant 4981860095 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
000557CTMDPhysician Assistant
25MP00497900NJMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orthonj LLC CurrentSince Sep 1, 2020 Accepting new patients
Orthonj LLC CurrentSince Sep 1, 2020 Accepting new patients
The Orthopaedic and Sports Medicine Center Past Accepting new patients
Connecticut Orthopaedic Specialists, PC Past Accepting new patients

Locations

2035 Lincoln Hwy
Edison, NJ 08817
Phone (732) 974-0404

2315 Route 34
Manasquan, NJ 08736
Phone (732) 974-0404

5 Plainsboro Rd
Ste 100
Plainsboro, NJ 08536
Phone (609) 750-1600

325 Princeton Ave
Princeton, NJ 08540
Phone (609) 924-5044

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569974400000",
    "number": "1770518607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 PRINCETON AVE",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085401617",
            "telephone_number": "609-924-8131",
            "fax_number": "609-924-8532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 PRINCETON AVE",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085401617",
            "telephone_number": "609-924-8131",
            "fax_number": "609-924-8532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIES",
        "first_name": "STEVEN",
        "middle_name": "P",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2019-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "000557",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00497900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Princeton, NJ

Sources for this page

Verify at the official NPI Registry.