Individual provider Active NPI

Mary Ellen J Terrels, DO

  • Family Medicine Physician
  • Egg Harbor City, NJ
National Provider Identifier
1033290606
Registry record updated Mar 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MB46954 Issued in NJ
Practice address
114 Cincinnati Ave
Egg Harbor City, NJ 08215-1926
Phone
(609) 965-2091
Fax
(609) 965-1585
NPI assigned
Oct 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MB46954 NJ Primary

Addresses

Primary practice location

114 Cincinnati Ave
Egg Harbor City, NJ 08215-1926

Mailing address

2500 English Creek Ave
Egg Harbor TWP, NJ 08234-5549

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070329000515 NJ Practitioner - Family PracticePractitioner - Osteopathic Manipulative Medicine 3375647480 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
MB46954NJMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Atlanticare Urgent Care Physicians LLC CurrentSince Jan 14, 2019 Accepting new patients
Atlanticare Physician Group PA Family Medicine CurrentSince Feb 1, 2007 Accepting new patients
Atlanticare Physician Group, PA CurrentSince Feb 1, 2007 Accepting new patients
Atlanticare Regional Medical Center Family Medicine Past Accepting new patients
Atlanticare Physician Group Past Accepting new patients

Locations

459 Route 9 S
Little Egg Harbor Twp, NJ 08087
Phone (609) 340-7815

1200 New Jersey Ave
North Wildwood, NJ 08260
Phone (609) 522-3131

255 N Route 73
West Berlin, NJ 08091
Phone (609) 569-7040

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205971200000",
    "number": "1033290606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 ENGLISH CREEK AVE",
            "city": "EGG HARBOR TWP",
            "state": "NJ",
            "postal_code": "082345549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 CINCINNATI AVE",
            "city": "EGG HARBOR CITY",
            "state": "NJ",
            "postal_code": "082151926",
            "telephone_number": "609-965-2091",
            "fax_number": "609-965-1585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERRELS",
        "first_name": "MARY ELLEN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-18",
        "last_updated": "2008-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "MB46954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Egg Harbor City, NJ

Sources for this page

Verify at the official NPI Registry.