Amerigroup New Jersey, Inc.

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

Legal business name

AMERIGROUP NEW JERSEY, INC.

Doing business as

AMERIGROUP Community Care

Practice address

399 Thornall St
Ninth Floor
Edison, NJ 08837-2236

Phone

(732) 452-6000

Fax

(732) 452-0407

NPI assigned

Dec 1, 2005

Last updated

Aug 22, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Peter D Haytaian

Title

Ceo and President

Phone

(732) 452-6000

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• AMERIGROUP Community Care Doing business as

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

{
    "created_epoch": "1133395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187740800000",
    "number": "1023092236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "399 THORNALL ST",
            "address_2": "NINTH FLOOR",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088372236",
            "telephone_number": "732-452-6000",
            "fax_number": "732-452-0407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "399 THORNALL ST",
            "address_2": "NINTH FLOOR",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088372236",
            "telephone_number": "732-452-6000",
            "fax_number": "732-452-0407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMERIGROUP NEW JERSEY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-01",
        "last_updated": "2007-08-22",
        "status": "A",
        "authorized_official_last_name": "HAYTAIAN",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO AND PRESIDENT",
        "authorized_official_telephone_number": "732-452-6000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "670043",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AMERIGROUP Community Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Health Maintenance Organization in Edison, NJ
• Providers in Edison, NJ by specialty
• Health Maintenance Organization in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2007; 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.