Advanced Gastroenterology of Northern NJ LLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

ADVANCED GASTROENTEROLOGY OF NORTHERN NJ LLC

Practice address

15 Arkansas Ave
Ocean City, NJ 08226-2962

Phone

(609) 382-0111

Fax

(201) 255-0668

NPI assigned

Oct 18, 2018

Last updated

Aug 9, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Brian M Berberian, MDNPI 1861422586

Title

Owner

Phone

(856) 745-2241

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 5

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.

• Brian Berberian, M.D.

  • Gastroenterology Physician
  • Bangor, ME
  • NPI 1861422586

  NJ

  Medicare reassignment Care Compare group Authorized official
• Stacey Lee Longo, M.D.

  • Clinical Pathology/Laboratory Medicine Physician
  • Eatontown, NJ
  • NPI 1184799223
  Medicare reassignment Care Compare group NPD
• Nguyen Vo, MD

  • Cytopathology Physician
  • Atlantic City, NJ
  • NPI 1053638858
  Medicare reassignment NPD
• John Ekladous, D.O.

  • Anatomic Pathology & Clinical Pathology Physician
  • Farmington, CT
  • NPI 1568705861

  NJ

  Medicare reassignment NPD
• Nicolle A Tepedino, MSN, APN

  • Adult Health Nurse Practitioner
  • Ventnor City, NJ
  • NPI 1619015880
  Medicare reassignment

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

{
    "created_epoch": "1539820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660003200000",
    "number": "1821564634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 ARKANSAS AVE",
            "city": "OCEAN CITY",
            "state": "NJ",
            "postal_code": "082262962",
            "telephone_number": "609-382-0111",
            "fax_number": "201-255-0668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 ARKANSAS AVE",
            "city": "OCEAN CITY",
            "state": "NJ",
            "postal_code": "082262962",
            "telephone_number": "609-382-0111",
            "fax_number": "201-255-0668"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "639 Teaneck Rd",
            "address_purpose": "LOCATION",
            "city": "Teaneck",
            "state": "NJ",
            "postal_code": "076664258",
            "country_code": "US",
            "telephone_number": "856-745-2241",
            "fax_number": "646-786-4040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ADVANCED GASTROENTEROLOGY OF NORTHERN NJ LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-18",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-09",
        "status": "A",
        "authorized_official_last_name": "BERBERIAN",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "856-745-2241",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL DOCTOR",
            "identifier": "25MA07878000",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Multi-Specialty Clinic/Center in Ocean City, NJ
• Providers in Ocean City, 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 Aug 9, 2022; 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.