Eastern Thoracic Surgical Associates LLC

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

Legal business name

EASTERN THORACIC SURGICAL ASSOCIATES LLC

Practice address

65 Mechanic St
Suite 102
Red Bank, NJ 07701-1869

Phone

(732) 741-9980

Fax

(732) 741-9982

NPI assigned

Apr 17, 2008

Organization subpart

No

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

Authorized official

Name

Lourens J Willekes II, M.D.

Title

Physician

Phone

(732) 741-9980

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1208390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248393600000",
    "number": "1881868263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 MECHANIC ST",
            "address_2": "SUITE 102",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077011869",
            "telephone_number": "732-741-9980",
            "fax_number": "732-741-9982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 MECHANIC ST",
            "address_2": "SUITE 102",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077011869",
            "telephone_number": "732-741-9980",
            "fax_number": "732-741-9982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN THORACIC SURGICAL ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-17",
        "last_updated": "2009-07-24",
        "status": "A",
        "authorized_official_last_name": "WILLEKES",
        "authorized_official_first_name": "LOURENS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "732-741-9980",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0077411",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2009; 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.