NPIMap

Princeton Healthcare Affiliated Physicians PC

Organization Active NPI Internal Medicine Physician · Monmouth Junction, NJ

NPI 1902201163 · NPPES record last updated Nov 16, 2020

Key facts

NPI
1902201163
Entity type
Organization (NPI type 2)
Primary specialty
Internal Medicine Physician 207R00000X
Legal business name
PRINCETON HEALTHCARE AFFILIATED PHYSICIANS PC
Practice address
540 Ridge Rd
Monmouth Junction, NJ 08852-2643
Phone
(609) 497-2230
Fax
(732) 274-0235
NPI assigned
Oct 30, 2014
Organization subpart
Yes
Parent organization (as reported)
PRINCETON HEALTHCARE AFFILIATED PHYSICIANS PC

Authorized official

Name
Steven R. Bergmann, MD PHD
Title
President
Phone
(609) 853-7220

Other NPIs on the same Medicare enrollment 19

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Corporate family (same tax ID) 16

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 13

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NJ

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20100413000141 NJ Part B Supplier - Clinic/Group Practice 2567598022 Receives reassigned benefits from 269 practitioners
19 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Plainsboro, NJ; Morganville, NJ; Princeton, NJ; Robbinsville, NJ; West Windsor, NJ; Monroe Township, NJ; Monmouth Junction, NJ; Lawrenceville, NJ…

National Provider Directory

Tax ID family
University Medical Center Medical Center in Plainsboro (17 organizations share this tax ID)
Part of
University Medical Center Medical Center in Plainsboro

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207R00000X Yes
Geriatric Medicine (Internal Medicine) Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207RG0300X
Family Nurse Practitioner
Group: 193200000X MULTI-SPECIALTY GROUP		 363LF0000X

Addresses

Primary practice location

540 Ridge Rd
Monmouth Junction, NJ 08852-2643

Mailing address

4 Princess Rd
Suite 207
Lawrenceville, NJ 08648-2322
Phone (609) 243-0445

Other names

  • Princeton Medicine at Monmouth Junction Doing business as

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 16, 2020.

{
    "created_epoch": "1414627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605484800000",
    "number": "1902201163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 PRINCESS RD",
            "address_2": "SUITE 207",
            "city": "LAWRENCEVILLE",
            "state": "NJ",
            "postal_code": "086482322",
            "telephone_number": "609-243-0445",
            "fax_number": "609-844-1092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 RIDGE RD",
            "city": "MONMOUTH JUNCTION",
            "state": "NJ",
            "postal_code": "088522643",
            "telephone_number": "609-497-2230",
            "fax_number": "732-274-0235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRINCETON HEALTHCARE AFFILIATED PHYSICIANS PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PRINCETON HEALTHCARE AFFILIATED PHYSICIANS PC",
        "enumeration_date": "2014-10-30",
        "last_updated": "2020-11-16",
        "certification_date": "2020-11-16",
        "status": "A",
        "authorized_official_last_name": "BERGMANN",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "609-853-7220",
        "authorized_official_credential": "MD PHD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Princeton Medicine at Monmouth Junction",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Princeton Medicine at Monmouth Junction",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Monmouth Junction, NJ

All providers in Monmouth Junction, NJ · Internal Medicine Physician in New Jersey

Sources for this page

Verify at the official NPI Registry.