NPIMap

Organization Active NPI

SD Middletown

  • Sleep Medicine (Family Medicine) Physician
  • Middletown, NJ
National Provider Identifier
1922513183
Registry record updated Apr 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sleep Medicine (Family Medicine) PhysicianTaxonomy code 207QS1201X
Legal business name
SD MIDDLETOWN
Practice address
1000 Hwy 35 Ste 102
Middletown, NJ 07748-2609
Phone
(732) 361-6855
NPI assigned
Dec 11, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2023

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

Authorized official

Name
Mr. Bryan Breslov
Title
Ceo
Phone
(732) 876-9075

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sleep Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QS1201X Primary

Addresses

Primary practice location

1000 Hwy 35 Ste 102
Middletown, NJ 07748-2609

Mailing address

1000 Hwy 35 Ste 102
Middletown, NJ 07748-2609
Phone (732) 361-6855

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180226000086 NJ Part B Supplier - Clinic/Group Practice 6103187695 Receives reassigned benefits from 7 practitioners
Practice locations: Middletown, NJ

National Provider Directory

National Provider Directory

Locations

1000 State Route 35
Ste 102
Middletown, NJ 07748
Phone (732) 361-6855

Practitioners & affiliated clinicians

Practitioners 7

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

NPI Registry JSON

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

{
    "created_epoch": "1512950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682380800000",
    "number": "1922513183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 HWY 35 STE 102",
            "city": "MIDDLETOWN",
            "state": "NJ",
            "postal_code": "077482609",
            "telephone_number": "732-361-6855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 HWY 35 STE 102",
            "city": "MIDDLETOWN",
            "state": "NJ",
            "postal_code": "077482609",
            "telephone_number": "732-361-6855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SD MIDDLETOWN",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-11",
        "last_updated": "2023-04-25",
        "certification_date": "2023-04-25",
        "status": "A",
        "authorized_official_last_name": "BRESLOV",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "732-876-9075",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207QS1201X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Sleep Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2023; 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.