Organization Active NPI

Middlesex Monmouth Gastroenterology

  • Anesthesiology Physician
  • Freehold, NJ
National Provider Identifier
1780970749
Registry record updated Jun 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
MIDDLESEX MONMOUTH GASTROENTEROLOGY
Practice address
222 Schanck Rd
Suite 100
Freehold, NJ 07728-3068
Phone
(732) 577-1999
Fax
(732) 845-5356
NPI assigned
Jun 28, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2011

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

Authorized official

Name
Susan Debard, MPA
Title
Administrator
Phone
(732) 577-1999

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X Primary

Addresses

Primary practice location

222 Schanck Rd
Suite 100
Freehold, NJ 07728-3068

Mailing address

222 Schanck Rd
Suite 100
Freehold, NJ 07728-3068
Phone (732) 577-1999

Other identifiers 1

IdentifierTypeStateIssuer
071151OtherNJMEDICARE PTAN

Other names 1

  • MMG Anesthesia Services Other name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1309219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309219200000",
    "number": "1780970749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 SCHANCK RD",
            "address_2": "SUITE 100",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077283068",
            "telephone_number": "732-577-1999",
            "fax_number": "732-845-5356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 SCHANCK RD",
            "address_2": "SUITE 100",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077283068",
            "telephone_number": "732-577-1999",
            "fax_number": "732-845-5356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDDLESEX MONMOUTH GASTROENTEROLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-28",
        "last_updated": "2011-06-28",
        "status": "A",
        "authorized_official_last_name": "DEBARD",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "732-577-1999",
        "authorized_official_credential": "MPA"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "071151",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MMG Anesthesia Services",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Freehold, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2011; 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.