NPIMap

Organization Active NPI

Monmouth Family Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Long Branch, NJ
National Provider Identifier
1790974996
Registry record updated Mar 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
23166 Issued in NJ
Legal business name
MONMOUTH FAMILY HEALTH CENTER, INC
Practice address
300 2ND Ave
Long Branch, NJ 07740-6303
Phone
(732) 923-7100
NPI assigned
Oct 24, 2007
Last updated
Mar 11, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2011

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

Authorized official

Name
Ms. Andrea Duncan
Title
Director, Finance
Phone
(732) 413-2020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 23166 NJ Primary

Addresses

Primary practice location

300 2ND Ave
Long Branch, NJ 07740-6303

Mailing address

270 Broadway
Long Branch, NJ 07740-7027
Phone (732) 923-7100

Other identifiers 1

IdentifierTypeStateIssuer
0032352MedicaidNJ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040805001258 NJ Part B Supplier - Clinic/Group Practice 0143291674 Receives reassigned benefits from 36 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Long Branch, NJ

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

270 Broadway
Long Branch, NJ 07740
Phone (732) 923-7100

335 Broadway
Long Branch, NJ 07740
Phone (732) 475-3800

80 Pavilion Ave
Long Branch, NJ 07740
Phone (732) 263-0101

Practitioners & affiliated clinicians

Practitioners 34

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.

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1193184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299801600000",
    "number": "1790974996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 BROADWAY",
            "city": "LONG BRANCH",
            "state": "NJ",
            "postal_code": "077407027",
            "telephone_number": "732-923-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 2ND AVE",
            "city": "LONG BRANCH",
            "state": "NJ",
            "postal_code": "077406303",
            "telephone_number": "732-923-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONMOUTH FAMILY HEALTH CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-24",
        "last_updated": "2011-03-11",
        "status": "A",
        "authorized_official_last_name": "DUNCAN",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "DIRECTOR, FINANCE",
        "authorized_official_telephone_number": "732-413-2020",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NJ",
            "license": "23166",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0032352",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Branch, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2011; 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.