SHREWSBURY VASCULAR AND GENERAL SURGERY ASSOCIATES LLC - NPI NUMBER 1154485332

Summary

Provider Name: SHREWSBURY VASCULAR AND GENERAL SURGERY ASSOCIATES LLC

NPI Number: 1154485332

Clasification: Surgery (208600000X)

Address:
655 SHREWSBURY AVE
SUITE 210
SHREWSBURY, NJ
ZIP 07702

Phone Number: (732) 747-4744



Detailed Information

SHREWSBURY VASCULAR AND GENERAL SURGERY ASSOCIATES LLC is a surgeon in Shrewsbury, NJ. The provider is a general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. The assigned NPI number for this provider is 1154485332 and is registered as an organization entity type and is a single specialty group.

The provider's business address is:

655 SHREWSBURY AVE
SUITE 210
SHREWSBURY, NJ
ZIP 07702-179
Phone: (732) 747-4744
Fax: (732) 747-4751

The provider's authorized official is Joseph E Cauda .
The authorized official title is Physician and has the following contact phone number (732) 747-4744.

The enumeration date for this NPI number is 12/21/2006 and was last updated on 1/16/2009.

Map - Location of Practice

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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 208600000X Surgery MA41837 NJ Yes

Other (Legacy) Identifiers

The following legacy identifiers are available for this provider:

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1 069353 MEDICARE ID-TYPE UNSPECIFIED
2 1392000 MEDICAID NJ
3 C55226 MEDICARE UPIN

NPI Record

No. Field Name Field Value Field Definition 1
1 NPI 1154485332 The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
2 Entity Type Code 2 Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
3 Employer Identification Number EIN The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
4 Provider Organization Name Legal Business Name SHREWSBURY VASCULAR AND GENERAL SURGERY ASSOCIATES LLC The name of the organization provider. If the provider is an organization, this is the legal business name.
5 Provider First Line Business Practice Location Address 655 SHREWSBURY AVE The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
6 Provider Second Line Business Practice Location Address SUITE 210 The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
7 Provider Business Practice Location Address City Name SHREWSBURY The city name in the location address of the provider being identified.
8 Provider Business Practice Location Address State Name NJ The State code in the location of the provider being identified.
9 Provider Business Practice Location Address Postal Code 077024179 The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
10 Provider Business Practice Location Address Country Code If outside U S US The country code in the location address of the provider being identified.
11 Provider Business Practice Location Address Telephone Number 7327474744 The telephone number associated with the location address of the provider being identified.
12 Provider Business Practice Location Address Fax Number 7327474751 The fax number associated with the location address of the provider being identified.
13 Provider Enumeration Date 12/21/2006 The date the provider was assigned a unique identifier (assigned an NPI).
14 Last Update Date 1/16/2009 The date that a record was last updated or changed.
15 Authorized Official Last Name CAUDA The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
16 Authorized Official First Name JOSEPH The first name of the authorized official.
17 Authorized Official Middle Name E The middle name of the authorized official.
18 Authorized Official Title or Position PHYSICIAN The title or position of the authorized official.
19 Authorized Official Telephone Number 7327474744 The 10-position telephone number of the authorized official.
20 Healthcare Provider Taxonomy Code 1 208600000X Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
21 Provider License Number 1 MA41837 The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
22 Provider License Number State Code 1 NJ The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
23 Healthcare Provider Primary Taxonomy Switch 1 Y
24 Other Provider Identifier 1 069353 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
25 Other Provider Identifier Type Code 1 04 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
26 Other Provider Identifier 2 1392000 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
27 Other Provider Identifier Type Code 2 05 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
28 Other Provider Identifier State 2 NJ
29 Other Provider Identifier 3 C55226 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
30 Other Provider Identifier Type Code 3 02 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
31 Is Organization Subpart N
32 Authorized Official Credential Text MD
33 Healthcare Provider Taxonomy Group 1 193400000X SINGLE SPECIALTY GROUP

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This page was last updated on: 3/10/2015

(1) Field Definition Source-. Federal Register / Vol. 69, No. 15 / Friday, January 23, 2004 / Rules and Regulations - Part II Department of Health and Human Services Office of the Secretary 45 CFR Part 162 HIPAA Administrative Simplification: Standard Unique Health Identifier for Health Care Providers; Final Rule

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