GARDEN STATE GASTROENTEROLOGY,PC
NPI 1215124524
Internal Medicine - Gastroenterology in Old Bridge, NJ
About Garden State Gastroenterology,pc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
GARDEN STATE GASTROENTEROLOGY,PC (NPI 1215124524) is a healthcare organization registered as a gastroenterology in Old Bridge, New Jersey and active in the NPI registry since October 2007. The organization holds a CLIA Certificate of Compliance certificate valid through August 14, 2027 and lists Tracey Drevelus Hom, Office Manager, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Garden State Gastroenterology,pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by January 31, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
5Medicare enrollment records show 5 clinicians reassign Medicare billing to Garden State Gastroenterology,pc, which bills Medicare for the services they deliver. Of these, 3 practice at this address and 4 within 10 miles. They are listed nearest first.
Clinicians, nearest first (5)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Compliance 31D2328720
Garden State Gastroenterology · Old Bridge, NJFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Garden State Gastroenterology,pc's NPI number?
The NPI number for Garden State Gastroenterology,pc is 1215124524. It was assigned to this organization in the NPPES registry on October 1, 2007.
Where is Garden State Gastroenterology,pc located?
Garden State Gastroenterology,pc is located at 200 Perrine Rd Suite 231, Old Bridge, NJ 08857. The listed phone number is (732) 525-0600.
What is Garden State Gastroenterology,pc's specialty?
The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.
Is Garden State Gastroenterology,pc enrolled in Medicare?
Yes. Garden State Gastroenterology,pc is registered in the Medicare PECOS enrollment system.
When is Garden State Gastroenterology,pc's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (New Jersey, Clinic/Group Practice) is due for revalidation by January 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Garden State Gastroenterology,pc?
According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians reassign their Medicare billing to Garden State Gastroenterology,pc, in Anesthesiology, Gastroenterology, Internal Medicine, Nurse Practitioner and Pathology. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 3 practice at this address and 4 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Garden State Gastroenterology,pc hold a CLIA laboratory certificate?
Yes. A Certificate of Compliance (number 31D2328720) is associated with this NPI, valid through August 14, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Garden State Gastroenterology,pc accept?
Health plans from Ambetter Health and Ambetter Health of Delaware list Garden State Gastroenterology,pc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Garden State Gastroenterology,pc was last updated on October 1, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Garden State Gastroenterology,pc · NPI 1215124524
Gastroenterology organization in Old Bridge, New Jersey. Organization record, active in the CMS NPPES registry since October 1, 2007.
## Identity
- **NPI:** 1215124524 (Entity type: Organization)
- **Enumerated:** October 1, 2007
- **Primary specialty:** Internal Medicine - Gastroenterology · taxonomy 207RG0100X
- **Organization subpart:** No
- **Authorized official:** Tracey Drevelus Hom, OFFICE MANAGER
## Practice location
- **Address:** 200 PERRINE RD, SUITE 231, Old Bridge, NJ 08857-2842
- **Phone:** (732) 525-0600 · **Fax:** (732) 525-9777
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** January 31, 2027 (Non-DME Part B, New Jersey, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 5 clinicians in 5 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Anesthesiology (1), Gastroenterology (1), Internal Medicine (1); 3 practice at this address and 4 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 1, 2007
- **Other identifiers:** Medicare PIN 078836 (NJ)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1215124524) · Data from the CMS NPPES public registry.