Woodbridge Medical Group, P.a

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MB30335 Issued in NJ

Legal business name

WOODBRIDGE MEDICAL GROUP, P.A

Doing business as

Main Street Physical Therapy

Practice address

270 Main St
Woodbridge, NJ 07095-1927

Phone

(732) 636-5252

Fax

(732) 636-5452

NPI assigned

May 10, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Robert D Boyd, D. ONPI 1548474257

Title

President

Phone

(732) 636-5252

Specialties & licenses 1

Addresses

Other names 1

• Main Street Physical Therapy Doing business as

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 1

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.

• Robert D Boyd, D.O

  • Family Medicine Physician
  • Woodbridge, NJ
  • NPI 1548474257
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194480000000",
    "number": "1881644011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 MAIN ST",
            "city": "WOODBRIDGE",
            "state": "NJ",
            "postal_code": "070951927",
            "telephone_number": "732-636-5252",
            "fax_number": "732-636-5452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 MAIN ST",
            "city": "WOODBRIDGE",
            "state": "NJ",
            "postal_code": "070951927",
            "telephone_number": "732-636-5252",
            "fax_number": "732-636-5452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODBRIDGE MEDICAL GROUP, P.A",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-10",
        "last_updated": "2007-11-08",
        "status": "A",
        "authorized_official_last_name": "BOYD",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "732-636-5252",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D. O"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "MB30335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Main Street Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Woodbridge Board of Education
• Woodbridge Centre Dental
• Woodbridge Dental LLC
• Woodbridge Dialysis Center LLC (Garden State Kidney Center)
• Woodbridge Medical Associates,P.a. (Woodbridge Internal Medical Associates)
• Woodbridge Sleep Center LLC
• Woodbridge Township School District
• Stephen D Yaremczak, D.M.D.
• Dick Oliver Lee Yeo, PT
• Omer Yetiskul, DDS

• Family Medicine Physician in Woodbridge, NJ
• Providers in Woodbridge, NJ by specialty
• Family Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2007; 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.