Affinity Surgical Associates, LLC
Organization Active NPI Neurological Surgery Physician · Paramus, NJ
NPI 1962854232 · NPPES record last updated Oct 18, 2022
Key facts
- NPI
- 1962854232
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Neurological Surgery Physician 207T00000X
- License
- MA067801 (NJ)
- Legal business name
- AFFINITY SURGICAL ASSOCIATES, LLC
- Practice address
- 205 Homestead Rd
Paramus, NJ 07652-4709 - Phone
- (516) 587-3406
- NPI assigned
- Jul 11, 2016
- Organization subpart
- No
Authorized official
- Name
- Tony Jacob, P.A.
- Title
- President
- Phone
- (516) 587-3406
Practitioners 1
-
Tony Jacob, PA-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20231005000068 | NJ | Part B Supplier - Clinic/Group Practice | 6608221049 |
Receives reassigned benefits from 1 practitioner Practice locations: Paramus, NJ |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurological Surgery Physician |
207T00000X | MA067801 | NJ | Yes |
Addresses
Primary practice location
205 Homestead Rd
Paramus, NJ 07652-4709
Mailing address
205 Homestead Rd
Paramus, NJ 07652-4709
Phone (516) 587-3406
Other providers in Paramus, NJ
- Advanced Practice Provider Group
- Advanced Treatment LLC
- Aelia Inc
- Aesthetic and Reconstructive Therapies LLC
- Affinity Care of North NJ LLC
- Ag Psychotherapy and Counseling Services LLC
- Amit Agarwal
- Anna Aghachi
- Danjela Ago
- Nastassia Aguilera
All providers in Paramus, NJ · Neurological Surgery Physician in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 18, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.