NPIMap

Organization Active NPI

Kenneth Faistl, MD,PA

Doing business as Family Practice of Central Jersey

  • Family Medicine Physician
  • Freehold, NJ
National Provider Identifier
1942277223
Registry record updated May 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
KENNETH FAISTL, MD,PA
Doing business as
Family Practice of Central Jersey
Practice address
17 Broad St
Freehold, NJ 07728-1703
Phone
(732) 462-9622
Fax
(732) 780-0014
NPI assigned
Mar 4, 2006
Last updated
May 20, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2008

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

Authorized official

Name
Dr. Kenneth W Faistl, MD
Title
Owner
Phone
(732) 462-9622

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

17 Broad St
Freehold, NJ 07728-1703

Mailing address

17 Broad St
Freehold, NJ 07728-1703
Phone (732) 462-9622

Other identifiers 1

IdentifierTypeStateIssuer
7461402MedicaidNJ

Other names 1

  • FAMILY PRACTICE OF CENTRAL JERSEY Doing business as

National Provider Directory

National Provider Directory

Locations

158 S Main St
Hightstown, NJ 08520
Phone (609) 298-2005

728 Newman Springs Rd
Lincroft, NJ 07738
Phone (732) 345-9772

Practitioners & affiliated clinicians

Practitioners 39

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.

View all 39

NPI Registry JSON

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

{
    "created_epoch": "1141430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211241600000",
    "number": "1942277223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 BROAD ST",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077281703",
            "telephone_number": "732-462-9622",
            "fax_number": "732-780-0014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 BROAD ST",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077281703",
            "telephone_number": "732-462-9622",
            "fax_number": "732-780-0014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNETH FAISTL, MD,PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-04",
        "last_updated": "2008-05-20",
        "status": "A",
        "authorized_official_last_name": "FAISTL",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-462-9622",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7461402",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FAMILY PRACTICE OF CENTRAL JERSEY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Freehold, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2008; 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.