Organization Active NPI

My MD Group LLC

  • Internal Medicine Physician
  • Jackson, NJ
National Provider Identifier
1811121916
Registry record updated Feb 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MA07276900 Issued in NJ
Legal business name
MY MD GROUP LLC
Practice address
19 N County Line Rd
Jackson, NJ 08527-1255
Phone
(732) 901-8880
Fax
(732) 901-0882
NPI assigned
May 5, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2011

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

Authorized official

Name
Dr. Nivedita Sharma, M.D.NPI 1932134855
Title
Medical Doctor
Phone
(732) 901-8880

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
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X MA07276900 NJ Primary

Addresses

Primary practice location

19 N County Line Rd
Jackson, NJ 08527-1255

Mailing address

PO Box 172
Manalapan, NJ 07726-0172
Phone (732) 901-8880

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090513000360 NJ Part B Supplier - Clinic/Group Practice 8527117001 Receives reassigned benefits from 2 practitioners
Practice locations: Jackson, NJ

National Provider Directory

National Provider Directory

Locations

201 N County Line Rd
Jackson, NJ 08527
Phone (732) 901-8880

Interoperability endpoints

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

Practitioners & affiliated clinicians

Practitioners 2

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": "1241481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1298592000000",
    "number": "1811121916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 172",
            "city": "MANALAPAN",
            "state": "NJ",
            "postal_code": "077260172",
            "telephone_number": "732-901-8880",
            "fax_number": "732-901-0882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 N COUNTY LINE RD",
            "city": "JACKSON",
            "state": "NJ",
            "postal_code": "085271255",
            "telephone_number": "732-901-8880",
            "fax_number": "732-901-0882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY MD GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-05",
        "last_updated": "2011-02-25",
        "status": "A",
        "authorized_official_last_name": "SHARMA",
        "authorized_official_first_name": "NIVEDITA",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "732-901-8880",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "MA07276900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 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.