Individual provider Active NPI

Max Masgudov, MD

  • Anesthesiology Physician
  • Philadelphia, PA
National Provider Identifier
1801877147
Registry record updated Jun 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
25MA11793000 Issued in NJ
Practice address
3401 N Broad St
Philadelphia, PA 19140-5103
Phone
(215) 707-3326
NPI assigned
Nov 11, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X MD477960 PA
Anesthesiology Physician 207L00000X 25MA11793000 NJ Primary

Addresses

Primary practice location

3401 N Broad St
Philadelphia, PA 19140-5103

Mailing address

331 Newman Springs Rd Ste 220
Red Bank, NJ 07701-5792
Phone (732) 807-0877

Other practice location 1

99 Beauvoir Ave
Summit, NJ 07901-3533
Phone (908) 522-2000

Other practice location 2

1945 State Route 33
Neptune, NJ 07753-4859
Phone (732) 776-4945

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230628001196 NJ Practitioner - Anesthesiology 8921141805 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hackensack Meridian Health Medical Group - Specialty Care PCGroup PAC ID 9133032519, 1,901 clinicians

Practice addresses (Care Compare)

19 Davis Ave
Neptune, NJ 07753-4488

1944 Route 33
Neptune, NJ 07753
Phone (732) 776-3787

1945 Route 33
Neptune, NJ 07753

3600 Route 66
FL 3
Neptune, NJ 07753

Hospital & facility affiliations

  • Jersey Shore University Medical Center Hospital, Neptune, NJ, CCN 310073

Merit-based Incentive Payment System (MIPS)

Final score
81.33 of 100Reported as group
Quality
66.38
Promoting interoperability
100
Improvement activities
40
Cost
71.39

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA11793000NJMDAnesthesiology Physician
MD477960PAMDAnesthesiology Physician
011055NYMDPediatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Apr 19, 2024 Accepting new patients
North American Partners in Anesthesia of New Jersey LLC Anesthesiology CurrentSince May 1, 2023 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Apr 19, 2024 Accepting new patients
Suny Downstate Medical Center Past Accepting new patients

Locations

1 Clara Maass Dr
Belleville, NJ 07109
Phone (973) 450-2008

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

300 2nd Ave
Long Branch, NJ 07740
Phone (732) 222-5200

1944 State Route 33
Neptune, NJ 07753
Phone (732) 776-3787

703 Main St
Paterson, NJ 07503
Phone (973) 754-2240

331 Newman Springs Rd
Ste 220
Red Bank, NJ 07701
Phone (732) 807-0514

99 Beauvoir Ave
Summit, NJ 07901
Phone (908) 522-2232

1945 State Route 33
Wall Township, NJ 07753
Phone (732) 776-2333

425 Jack Martin Blvd
Wall Township, NJ 08724
Phone (732) 840-2200

1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD

Organizations & group practices 5

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1131667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718582400000",
    "number": "1801877147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 NEWMAN SPRINGS RD STE 220",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077015792",
            "telephone_number": "732-807-0877",
            "fax_number": "201-751-1680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405103",
            "telephone_number": "215-707-3326"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "99 Beauvoir Ave",
            "address_purpose": "LOCATION",
            "city": "Summit",
            "state": "NJ",
            "postal_code": "079013533",
            "country_code": "US",
            "telephone_number": "908-522-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1945 State Route 33",
            "address_purpose": "LOCATION",
            "city": "Neptune",
            "state": "NJ",
            "postal_code": "077534859",
            "country_code": "US",
            "telephone_number": "732-776-4945",
            "fax_number": "732-776-4550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MASGUDOV",
        "first_name": "MAX",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-11",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "PA",
            "license": "MD477960",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NJ",
            "license": "25MA11793000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.