Heritage General and Colorectal Surgery, PA

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

HERITAGE GENERAL AND COLORECTAL SURGERY, PA

Practice address

741 Teaneck Rd
Suite B
Teaneck, NJ 07666-4243

Phone

(201) 833-2888

NPI assigned

Nov 2, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Farshad MansouriNPI 1689830572

Title

President

Phone

(716) 523-7930

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 3

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

• Farshad Mansouri, MD

  • Colon & Rectal Surgery Physician
  • Teaneck, NJ
  • NPI 1689830572
  Medicare reassignment Care Compare group NPD Authorized official
• Adam Paul Andriulli, PA-C

  • Surgical Physician Assistant
  • Oakland, NJ
  • NPI 1619442746
  Medicare reassignment Care Compare group
• Briana Marie Miller, PA

  • Surgical Physician Assistant
  • Neptune, NJ
  • NPI 1932689486
  Medicare reassignment

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

{
    "created_epoch": "1478044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478044800000",
    "number": "1912459348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "741 TEANECK RD",
            "address_2": "SUITE B",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076664243",
            "telephone_number": "201-833-2888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "741 TEANECK RD",
            "address_2": "SUITE B",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076664243",
            "telephone_number": "201-833-2888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE GENERAL AND COLORECTAL SURGERY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-02",
        "last_updated": "2016-11-02",
        "status": "A",
        "authorized_official_last_name": "MANSOURI",
        "authorized_official_first_name": "FARSHAD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "716-523-7930",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Colon & Rectal Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hematology Oncology Partners, PC
• Nia Henderson, LCSW
• Terry W Hensle, M.D, LLC
• Lacey M Herald, PA
• Heritage Breast Care LLC
• Heritage Surgical Group, LLC
• Kevin Herman, M.D.
• Hitandewy J Hernandez-Herrera
• Iris Nereyda Hernandez, BCBA
• Ryan Hernandez, APN

• Surgery Physician in Teaneck, NJ
• Providers in Teaneck, NJ by specialty
• Surgery Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2016; 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.