Individual provider Active NPI

Michael S Entmacher, MD

  • Hematology & Oncology Physician
  • Mount Holly, NJ
National Provider Identifier
1053346304
Registry record updated Oct 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
MA04456 Issued in NJ
Practice address
175 Madison Avenue
4TH Floor Stokes Building
Mt Holly, NJ 08060
Phone
(609) 702-1900
Fax
(609) 702-8455
NPI assigned
Jul 12, 2006
Last updated
Oct 30, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X MA04456 NJ Primary

Addresses

Primary practice location

175 Madison Avenue
4TH Floor Stokes Building
Mt Holly, NJ 08060

Mailing address

175 Madison Avenue
4TH Floor Stokes Building
Mt Holly, NJ 08060
Phone (609) 702-1900

Other identifiers 3

IdentifierTypeStateIssuer
33716OtherAETNA
110046923OtherRAILROAD MEDICARE
4527101MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MA04456NJMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hematology Oncology Associates, SJ, PA Hematology & Oncology Current Accepting new patients

Locations

175 Madison Ave
Fl 4
Mount Holly, NJ 08060
Phone (609) 702-1900

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256860800000",
    "number": "1053346304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 MADISON AVENUE",
            "address_2": "4TH FLOOR STOKES BUILDING",
            "city": "MT HOLLY",
            "state": "NJ",
            "postal_code": "08060",
            "telephone_number": "609-702-1900",
            "fax_number": "609-702-8455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 MADISON AVENUE",
            "address_2": "4TH FLOOR STOKES BUILDING",
            "city": "MT HOLLY",
            "state": "NJ",
            "postal_code": "08060",
            "telephone_number": "609-702-1900",
            "fax_number": "609-702-8455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENTMACHER",
        "first_name": "MICHAEL",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2009-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NJ",
            "license": "MA04456",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "33716",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110046923",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4527101",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Holly, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2009; 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.