NPIMap

Organization Active NPI

Coastal Ear Nose and Throat, LLC

  • Otolaryngology Physician
  • Neptune, NJ
National Provider Identifier
1861592867
Registry record updated Mar 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
COASTAL EAR NOSE AND THROAT, LLC
Practice address
3700 Route 33
Suite 101
Neptune, NJ 07753
Phone
(732) 280-7855
Fax
(732) 280-7815
NPI assigned
Sep 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2018

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

Authorized official

Name
Lisa J. Hanson
Title
Office Manager
Phone
(732) 280-7855

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X
Otolaryngology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Y00000X Primary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X 40QA01137200 NJ

Addresses

Primary practice location

3700 Route 33
Suite 101
Neptune, NJ 07753

Mailing address

3700 Route 33
Suite 101
Neptune, NJ 07753
Phone (732) 280-7855

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070324000108 NJ Part B Supplier - Clinic/Group Practice 2264536697 Receives reassigned benefits from 19 practitioners
Practice locations: Holmdel, NJ; Manahawkin, NJ; Neptune, NJ

National Provider Directory

National Provider Directory

Locations

100 Commons Way
Ste 210
Holmdel, NJ 07733

3700 State Route 33
Ste 101
Neptune, NJ 07753
Phone (732) 280-5055

Practitioners & affiliated clinicians

Practitioners 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522108800000",
    "number": "1861592867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 ROUTE 33",
            "address_2": "SUITE 101",
            "city": "NEPTUNE",
            "state": "NJ",
            "postal_code": "07753",
            "telephone_number": "732-280-7855",
            "fax_number": "732-280-7815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 ROUTE 33",
            "address_2": "SUITE 101",
            "city": "NEPTUNE",
            "state": "NJ",
            "postal_code": "07753",
            "telephone_number": "732-280-7855",
            "fax_number": "732-280-7815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL EAR NOSE AND THROAT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2018-03-27",
        "status": "A",
        "authorized_official_last_name": "HANSON",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "732-280-7855"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01137200",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Neptune, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2018; 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.