Organization Active NPI

Roselle Park Medical Associates LLC

  • Internal Medicine Physician
  • Roselle Park, NJ
National Provider Identifier
1851450373
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
ROSELLE PARK MEDICAL ASSOCIATES LLC
Practice address
744 Galloping Hill Rd
Roselle Park, NJ 07204-1700
Phone
(908) 241-0044
Fax
(908) 298-0583
NPI assigned
Dec 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Robert Solomon, MDNPI 1376602805
Title
President
Phone
(908) 241-0044

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 Primary

Addresses

Primary practice location

744 Galloping Hill Rd
Roselle Park, NJ 07204-1700

Mailing address

744 Galloping Hill Rd
Roselle Park, NJ 07204-1700
Phone (908) 241-0044

Other identifiers 1

IdentifierTypeStateIssuer
3143406MedicaidNJ

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
31D0108868Roselle Park Medical Associates744 Galloping Hill Rd, Roselle Park, NJ 07204Certificate of waiverMar 10, 2027

National Provider Directory

National Provider Directory

Locations

744 Galloping Hill Rd
#R
Roselle Park, NJ 07204
Phone (905) 241-0044

Practitioners & affiliated clinicians

Practitioners 4

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": "1165536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1851450373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "744 GALLOPING HILL RD",
            "city": "ROSELLE PARK",
            "state": "NJ",
            "postal_code": "072041700",
            "telephone_number": "908-241-0044",
            "fax_number": "908-298-0583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "744 GALLOPING HILL RD",
            "city": "ROSELLE PARK",
            "state": "NJ",
            "postal_code": "072041700",
            "telephone_number": "908-241-0044",
            "fax_number": "908-298-0583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSELLE PARK MEDICAL ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SOLOMON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "908-241-0044",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3143406",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roselle Park, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.