NPIMap

Organization Active NPI

Promed Preferred MD Professional Corporation

  • Internal Medicine Physician
  • Toms River, NJ
National Provider Identifier
1831934868
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
PROMED PREFERRED MD PROFESSIONAL CORPORATION
Practice address
277 Route 70 Ste 231
Toms River, NJ 08755-1569
Phone
(615) 499-3165
NPI assigned
Jul 1, 2024
Last updated
Jul 1, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

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

Authorized official

Name
Lev Grinman, MDNPI 1457511743
Title
Physician
Phone
(615) 499-3165

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: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

277 Route 70 Ste 231
Toms River, NJ 08755-1569

Mailing address

4 Legends Cir
Melville, NY 11747-5302
Phone (615) 499-3165

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20240910000772 MD Part B Supplier - Clinic/Group Practice 3577003110 Receives reassigned benefits from 8 practitioners
Practice locations: Lutherville, MD
O20250416002655 DC Part B Supplier - Clinic/Group Practice 3577003110 Receives reassigned benefits from 8 practitioners
Practice locations: Lutherville, MD

National Provider Directory

National Provider Directory
Tax ID family
Promed Preferred DC Professional Corporation2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1719792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719792000000",
    "number": "1831934868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 LEGENDS CIR",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117475302",
            "telephone_number": "615-499-3165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "277 ROUTE 70 STE 231",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087551569",
            "telephone_number": "615-499-3165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROMED PREFERRED MD PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-01",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A",
        "authorized_official_last_name": "GRINMAN",
        "authorized_official_first_name": "LEV",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "615-499-3165",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toms River, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2024; 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.