NPIMap

Organization Active NPI

HMH Hospitals Corporation

Doing business as HMH Behavioral Health Home

  • Clinic/Center
  • Neptune, NJ
National Provider Identifier
1053880286
Registry record updated Nov 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
HMH HOSPITALS CORPORATION
Doing business as
HMH Behavioral Health Home
Practice address
1200 Jumping Brook Rd.
BLDG 5, Ste 201
Neptune, NJ 07753
Phone
(732) 643-4400
Fax
(732) 643-4378
NPI assigned
Nov 16, 2018
Last updated
Nov 16, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
HMH HOSPITALS CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 16, 2018

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

Authorized official

Name
Marilyn Koczan
Title
VP Revenue Cycle
Phone
(732) 897-7800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

1200 Jumping Brook Rd.
BLDG 5, Ste 201
Neptune, NJ 07753

Mailing address

1200 Jumping Brook Rd., BLDG 5, Ste 201
Attn: Behavioral Health Credentialing
Neptune, NJ 07753
Phone (732) 643-4372

Other names 1

  • HMH Behavioral Health Home Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180208001055 NJ Part A Provider - Hospital 9032181847 2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Neptune, NJ; Neptune City, NJ; Manalapan, NJ

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1053880286. Details of each certification follow.

Hospital certification: CCN 310073

Legal name
HMH HOSPITALS CORPORATION
Doing business as
JERSEY SHORE UNIVERSITY MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Apr 15, 2022
Beds
596
Ownership / control type
Private (not for profit)
Most recent change of ownership
Jan 1, 2018 (4 total)
Organization structure
CorporationNon-profit
Incorporated
May 2, 1888 in NJ
Enrollment address
1945 State Route 33
Neptune, NJ 77534859
Main/Primary Hospital Location
Hospital subgroups
Acute care

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs on the same Medicare enrollment 2

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Jersey Shore University Medical CenterCCN 310073 · All quality measures
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
George B Jacobs MD45 organizations share this tax ID, including this one
Part of
George B Jacobs MD

Other organizations with this tax ID 44

Organizations that report the same tax identification number in the National Provider Directory.

View all 44

Ownership & related parties

All disclosed owners & managing parties 29

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

NameRoleSinceShare
Gloria D Martini Individual Corporate DirectorBoard Member Jan 1, 2018
Praful Raja Individual Corporate DirectorBoard Member Jan 1, 2022
Frank L Fekete Individual Corporate DirectorChair, HMH Board of Trustees Jan 1, 2023
Richard Henning Individual Corporate DirectorImmediate Past Chairperson Jan 1, 2023
Edward Piccinich Individual Corporate DirectorBoard Member Jan 1, 2018
Thomas R Lake Individual Corporate DirectorTreasurer Jan 1, 2018
Marvin Goldstein Individual Corporate DirectorBoard Member Jan 1, 2018
Edward Russo Individual Corporate DirectorBoard Member Jan 1, 2023
William J Murray Individual Corporate DirectorBoard Member Jan 1, 2018
Frank Vuono Individual Corporate DirectorSecretary Jan 1, 2023
Walter a. Wynkoop Individual Corporate DirectorBoard Member Jan 1, 2018
William Lawless Individual Corporate DirectorBoard Member Jan 1, 2018
Rosemarie Sorce Individual Corporate DirectorChairperson Jan 1, 2023
Shawn Reynolds Individual Corporate DirectorVice Chairperson Jan 1, 2023
Richard Hand Individual Corporate Officer Jul 1, 2016
Gregorio J Guillen Individual Corporate DirectorBoard Member Jan 1, 2018
Kathryn Gibbons Individual Corporate OfficerSenior VP- Budget, Reimb & Decision Sep 1, 2022
Christopher Rotio Individual Corporate DirectorBoard Member Jan 1, 2022
Pranaychandra J Vaidya Individual Corporate DirectorBoard Member Jan 1, 2018
Luke Kealy Individual Corporate DirectorBoard Member Jan 1, 2018
Andria Schneiderman Individual Corporate DirectorBoard Member Jan 1, 2018
John J Wilcha Individual Corporate DirectorBoard Member Jan 1, 2018
Hackensack Meridian Health Inc Organization, Edison, NJ Corporation, Non-profit 5% Or Greater Direct Ownership Interest Jan 1, 2018 100%
Kevin Field Individual Corporate DirectorNetwork Director - Reimbursement Jan 1, 2021
James Derosa Individual Corporate OfficerExecutive Vice President - Finance Dec 1, 2022
Robert C Garrett Individual Corporate OfficerCeo HMH Hospitals Corporation Jan 1, 2023
Corporate DirectorCo-Ceo Jan 1, 2023
Steve P Lisser Individual Corporate DirectorChair, Medical Council Jan 1, 2023
Mark S Stauder Individual Corporate OfficerCoo, President HMH Hospital Corp Jan 1, 2023
Corporate DirectorCoo, President HMH Hospitals Cor Jan 1, 2023
W-2 Managing EmployeeBoard Member Jan 1, 2022
Aida P Capo Individual Corporate DirectorBoard Member Jan 1, 2018

Owners & managing parties with NPI records 6

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Affiliated clinicians 1,685

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 1,685

NPI Registry JSON

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

{
    "created_epoch": "1542326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1542326400000",
    "number": "1053880286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 JUMPING BROOK RD., BLDG 5, STE 201",
            "address_2": "ATTN: BEHAVIORAL HEALTH CREDENTIALING",
            "city": "NEPTUNE",
            "state": "NJ",
            "postal_code": "07753",
            "telephone_number": "732-643-4372",
            "fax_number": "732-643-4376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 JUMPING BROOK RD.",
            "address_2": "BLDG 5, STE 201",
            "city": "NEPTUNE",
            "state": "NJ",
            "postal_code": "07753",
            "telephone_number": "732-643-4400",
            "fax_number": "732-643-4378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HMH HOSPITALS CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HMH HOSPITALS CORPORATION",
        "enumeration_date": "2018-11-16",
        "last_updated": "2018-11-16",
        "status": "A",
        "authorized_official_last_name": "KOCZAN",
        "authorized_official_first_name": "MARILYN",
        "authorized_official_title_or_position": "VP REVENUE CYCLE",
        "authorized_official_telephone_number": "732-897-7800"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HMH Behavioral Health Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Neptune, NJ

Sources for this page

Verify at the official NPI Registry.