Individual provider Active NPI

James A Matsuk Jr., RPH

  • Pharmacist
  • Mantua, NJ
National Provider Identifier
1871808451
Registry record updated Aug 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
28RI01463100 Issued in NJ
Practice address
210 Bridgeton Pike
Mantua, NJ 08051-1915
Phone
(856) 468-5513
Fax
(856) 468-4629
NPI assigned
Aug 8, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 28RI01463100 NJ Primary

Addresses

Primary practice location

210 Bridgeton Pike
Mantua, NJ 08051-1915

Mailing address

210 Bridgeton Pike
Mantua, NJ 08051-1915
Phone (856) 468-5513

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
28RI01463100NJMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Eckerd Corporation Past Accepting new patients
Eckerd Corporation Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1281225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281225600000",
    "number": "1871808451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 BRIDGETON PIKE",
            "city": "MANTUA",
            "state": "NJ",
            "postal_code": "080511915",
            "telephone_number": "856-468-5513",
            "fax_number": "856-468-4629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 BRIDGETON PIKE",
            "city": "MANTUA",
            "state": "NJ",
            "postal_code": "080511915",
            "telephone_number": "856-468-5513",
            "fax_number": "856-468-4629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATSUK",
        "first_name": "JAMES",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-08",
        "last_updated": "2010-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI01463100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mantua, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2010; 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.