NPIMap

Organization Active NPI

Ocean Health Initiatives Inc

  • Federally Qualified Health Center (FQHC)
  • Lakewood, NJ
National Provider Identifier
1043306574
Registry record updated Sep 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
OCEAN HEALTH INITIATIVES INC
Practice address
101 2ND St
Lakewood, NJ 08701-3324
Phone
(732) 363-6655
Fax
(732) 363-6656
NPI assigned
Oct 4, 2006
Last updated
Sep 14, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2023

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

Authorized official

Name
Theresa Berger
Title
C.E.O.
Phone
(732) 719-1511

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU
Adult Medicine Physician 207QA0505X NU
Obstetrics & Gynecology Physician 207V00000X NU
Pediatrics Physician 208000000X NU
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

101 2ND St
Lakewood, NJ 08701-3324

Mailing address

3600 Route 66 Ste 400
Neptune, NJ 07753-2645
Phone (732) 363-6655

Other identifiers 3

IdentifierTypeStateIssuer
0076244MedicaidNJ
0026590MedicaidNJ
0249785MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040405001022 NJ Part B Supplier - Clinic/Group Practice 2062405277 Receives reassigned benefits from 136 practitioners
6 other NPIs on this enrollment
Practice locations: Toms River, NJ; Little Egg Harbor, NJ; Lakewood, NJ; Freehold, NJ; Clifton, NJ; Brick, NJ
O20101122001164 NJ Part A Provider - Federally Qualified Health Center (FQHC) 2062405277 Practice locations: Lakewood, NJ

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1043306574. Details of each certification follow.

Federally qualified health center certification: CCN 311842

Legal name
OCEAN HEALTH INITIATIVES, INC
Organization structure
CorporationNon-profit
Incorporated
Apr 25, 2003 in NJ
Enrollment address
101 2ND St
Lakewood, NJ 87013324

Other NPIs with the same Medicare PAC ID 9

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 7

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Debra Levinson Individual Corporate Director Aug 1, 2008
Danny Goldberg Individual Corporate Director Apr 28, 2009
Catherine Ainora Individual Corporate Director Oct 1, 2010
Anthony Lombardino, MD Individual Corporate Officer Jan 1, 2013
Corporate Director Jan 1, 2013
John Craddox Individual Corporate Director Feb 1, 2007
Jorge Rod Individual Corporate Director Nov 1, 2008
Theresa Berger Individual Corporate OfficerBoard Chair Jan 5, 2011
Corporate DirectorCeo Jan 5, 2011 100%
W-2 Managing EmployeeCeo Jan 5, 2011 100%

Practitioners & affiliated clinicians

Practitioners 138

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 138

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694649600000",
    "number": "1043306574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 ROUTE 66 STE 400",
            "city": "NEPTUNE",
            "state": "NJ",
            "postal_code": "077532645",
            "telephone_number": "732-363-6655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 2ND ST",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087013324",
            "telephone_number": "732-363-6655",
            "fax_number": "732-363-6656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OCEAN HEALTH INITIATIVES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2023-09-14",
        "certification_date": "2023-09-14",
        "status": "A",
        "authorized_official_last_name": "BERGER",
        "authorized_official_first_name": "THERESA",
        "authorized_official_title_or_position": "C.E.O.",
        "authorized_official_telephone_number": "732-719-1511"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0076244",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0026590",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0249785",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, NJ

Sources for this page

Verify at the official NPI Registry.