Organization Active NPI

Old Tappan Medical Group, PA

  • Pediatrics Physician
  • Old Tappan, NJ
National Provider Identifier
1912916693
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
OLD TAPPAN MEDICAL GROUP, PA
Practice address
215 Old Tappan Rd
Old Tappan, NJ 07675-7000
Phone
(201) 666-1000
Fax
(201) 666-7610
NPI assigned
Aug 5, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Dr. Stephen G Varhol, M.D.NPI 1457369357
Title
President
Phone
(201) 666-1000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

215 Old Tappan Rd
Old Tappan, NJ 07675-7000

Mailing address

215 Old Tappan Rd
Old Tappan, NJ 07675-7000
Phone (201) 666-1000

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1912916693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 OLD TAPPAN RD",
            "city": "OLD TAPPAN",
            "state": "NJ",
            "postal_code": "076757000",
            "telephone_number": "201-666-1000",
            "fax_number": "201-666-7610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 OLD TAPPAN RD",
            "city": "OLD TAPPAN",
            "state": "NJ",
            "postal_code": "076757000",
            "telephone_number": "201-666-1000",
            "fax_number": "201-666-7610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLD TAPPAN MEDICAL GROUP, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-05",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "VARHOL",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-666-1000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Old Tappan, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.