Bridgewater Medical Group

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

BRIDGEWATER MEDICAL GROUP

Practice address

766 US Highway 202/206 North
Suite 1
Bridgewater, NJ 08807-1773

Phone

(908) 722-0808

Fax

(908) 722-3415

NPI assigned

Jun 13, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Robert H Lustig, D.O.

Title

President

Phone

(908) 722-0808

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Myron A Bergman, DPM

  • Podiatrist
  • Bridgewater, NJ
  • NPI 1710092374
  NPD (past)
• Jason Michael Kloby, PA

  • Physician Assistant
  • Bridgewater, NJ
  • NPI 1659465524
  NPD (past)
• Devraj Lahiri, M.D.

  • Internal Medicine Physician
  • Somerset, NJ
  • NPI 1356393458

  Obesity Medicine

  NPD (past)
• Zachary Paul Sheridan, PA

  • Physician Assistant
  • Bridgewater, NJ
  • NPI 1164310769
  NPD (past)
• Michele M Terroni, PA-C

  • Physician Assistant
  • Bridgewater, NJ
  • NPI 1801061072
  NPD (past)
• Jan I Wolitzky, PAC

  • Medical Physician Assistant
  • Bridgewater, NJ
  • NPI 1154364768
  NPD (past)
• Edward George Boss, PA

  • Physician Assistant
  • Raleigh, NC
  • NPI 1154485043
  NPD (past)
• Rebecca Grossman Ospital, PA-C

  • Medical Physician Assistant
  • Chevy Chase, MD
  • NPI 1598947129
  NPD (past)

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340150400000",
    "number": "1821031568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "766 US HIGHWAY 202/206",
            "address_2": "SUITE 1",
            "city": "BRIDGEWATER",
            "state": "NJ",
            "postal_code": "088071777",
            "telephone_number": "908-722-0808",
            "fax_number": "908-722-3415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "766 US HIGHWAY 202/206 NORTH",
            "address_2": "SUITE 1",
            "city": "BRIDGEWATER",
            "state": "NJ",
            "postal_code": "088071773",
            "telephone_number": "908-722-0808",
            "fax_number": "908-722-3415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGEWATER MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-13",
        "last_updated": "2012-06-20",
        "status": "A",
        "authorized_official_last_name": "LUSTIG",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "908-722-0808",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA US HEALTHCARE GROUP",
            "identifier": "2182",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2790203",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bridgewater Ambulatory Surgery Center, LLC
• Bridgewater Assisted Living Venture, LLC
• Bridgewater Dental Associates, PC
• Bridgewater Family Dental
• Bridgewater Internal Medicine
• Bridgewater Medical Group PA
• Bridgewater Opco, LLC
• Bridgewater Optometric Center
• Bridgewater Pediatrics, LLC
• Bridgewater Senior Care, LLC

• Multi-Specialty Clinic/Center in Bridgewater, NJ
• Providers in Bridgewater, NJ by specialty
• Multi-Specialty Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2012; 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.