Shore Nurse Practitioner Group LLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

26NJ00037000 Issued in NJ

Legal business name

SHORE NURSE PRACTITIONER GROUP LLC

Practice address

71 Annapolis St
Tinton Falls, NJ 07712-3175

Phone

(848) 466-6011

Fax

(732) 493-8475

NPI assigned

Nov 5, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Mustak Rahman, CPC,CPC-H

Title

Manager

Phone

(848) 466-6011

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Practitioners 3

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.

• Rosario Conde, ANP

  • Family Nurse Practitioner
  • Tinton Falls, NJ
  • NPI 1730263427
  Medicare reassignment NPD
• Renee M Nadal, APN

  • Family Nurse Practitioner
  • Long Branch, NJ
  • NPI 1063775047
  Medicare reassignment NPD
• Delfin George C. Ibanez, MD

  • Psychiatry Physician
  • Freehold, NJ
  • NPI 1144292210
  NPD (past)

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

{
    "created_epoch": "1257379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257379200000",
    "number": "1922335371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 ANNAPOLIS ST",
            "city": "TINTON FALLS",
            "state": "NJ",
            "postal_code": "077123175",
            "telephone_number": "848-466-6011",
            "fax_number": "732-493-8475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 ANNAPOLIS ST",
            "city": "TINTON FALLS",
            "state": "NJ",
            "postal_code": "077123175",
            "telephone_number": "848-466-6011",
            "fax_number": "732-493-8475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHORE NURSE PRACTITIONER GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-05",
        "last_updated": "2009-11-05",
        "status": "A",
        "authorized_official_last_name": "RAHMAN",
        "authorized_official_first_name": "MUSTAK",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "848-466-6011",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPC,CPC-H"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ00037000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard T. Sheerin, D.C.
• Shi-IV SHD Tinton Falls, NJ (All American @ Tinton Falls)
• Shore Care Pediatrics L.L.C.
• Shore Express Medical LLC
• Shore Healthcare Consultants
• Shore Orthopaedic Group
• Shore Orthopaedic Group LLC (shore orthopaedic group)
• SHP V Shrewsbury LLC (Arbor Terrace of Shrewsbury)
• Adrian Sia
• Robert Benjamin Sica, PH.D.

• Nurse Practitioner in Tinton Falls, NJ
• Providers in Tinton Falls, NJ by specialty
• Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2009; 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.