Oak Tree Family Practice, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

25MB06391200 Issued in NJ

Legal business name

OAK TREE FAMILY PRACTICE, LLC

Practice address

173 Essex Ave
Suite 101
Metuchen, NJ 08840-2281

Phone

(732) 321-5100

Fax

(732) 321-5252

NPI assigned

Sep 16, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Paul M Ahn, D.O.NPI 1609934298

Title

Medical Director

Phone

(732) 321-5100

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Tax ID family

Oak Tree Family Practice2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Oaktree Family Practice

  • Family Medicine Physician
  • Metuchen, NJ
  • NPI 1417370883
  NPD tax ID

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/EDADCA

Practitioners 1

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

• Paul Michael Ahn, D.O.

  • Family Medicine Physician
  • Metuchen, NJ
  • NPI 1609934298
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1221523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421280000000",
    "number": "1992954887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "173 ESSEX AVE",
            "address_2": "SUITE 101",
            "city": "METUCHEN",
            "state": "NJ",
            "postal_code": "088402281",
            "telephone_number": "732-321-5100",
            "fax_number": "732-321-5252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "173 ESSEX AVE",
            "address_2": "SUITE 101",
            "city": "METUCHEN",
            "state": "NJ",
            "postal_code": "088402281",
            "telephone_number": "732-321-5100",
            "fax_number": "732-321-5252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAK TREE FAMILY PRACTICE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-16",
        "last_updated": "2015-01-15",
        "status": "A",
        "authorized_official_last_name": "AHN",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "732-321-5100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MB06391200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Deepa Nyayapathi, DMD
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• Olga Diamantis Psychotherapy LLC

• Family Medicine Physician in Metuchen, NJ
• Providers in Metuchen, NJ by specialty
• Family Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2015; 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.