Optum Medical Care of New Jersey PC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

OPTUM MEDICAL CARE OF NEW JERSEY PC

Practice address

1 Maywood Ave
Maywood, NJ 07607-1001

Phone

(201) 464-4772

NPI assigned

Jan 2, 2019

Organization subpart

No

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

Authorized official

Name

Gaurang Ravaji Brahmbhatt, MD

Title

Cmo

Phone

(201) 706-8490

Specialties & licenses 1

Addresses

Other names 1

• Riverside Medical Group Doing business as

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

{
    "created_epoch": "1546387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685664000000",
    "number": "1902379977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HARMON PLZ FL 10",
            "city": "SECAUCUS",
            "state": "NJ",
            "postal_code": "070942803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MAYWOOD AVE",
            "city": "MAYWOOD",
            "state": "NJ",
            "postal_code": "076071001",
            "telephone_number": "201-464-4772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTUM MEDICAL CARE OF NEW JERSEY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-02",
        "last_updated": "2023-06-02",
        "certification_date": "2023-06-02",
        "status": "A",
        "authorized_official_last_name": "BRAHMBHATT",
        "authorized_official_first_name": "GAURANG",
        "authorized_official_middle_name": "RAVAJI",
        "authorized_official_title_or_position": "CMO",
        "authorized_official_telephone_number": "201-706-8490",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Riverside Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Matthew Nilsen-Remedios, L.AC.
• Nurse Practitioner Professional Services Inc
• Joseph N Nuziale, DC
• Soon Ja Oh, APN
• Vincent C Okabekwa, M.D.
• Lauren Otaguro
• Demetrios Nicholas Panagiotou, M.D.
• Nitin Nick Patel, M.D.
• Shalin B Patel, DC
• Pediatric Neurosurgeons of New Jersey, PC

• All providers in Maywood, NJ
• Durable Medical Equipment & Medical Supplies in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2023; 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.