Individual provider Active NPI

Eduardo Francisco Enriquez, M.D.

  • Internal Medicine Physician
  • Voorhees, NJ
National Provider Identifier
1063573616
Registry record updated Feb 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA05198500 Issued in NJ
Practice address
3 Brendenwood Dr
Voorhees, NJ 08043-1603
Phone
(856) 874-0202
Fax
(856) 874-0220
NPI assigned
Dec 13, 2006
Last updated
Feb 11, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MA05198500 NJ Primary

Addresses

Primary practice location

3 Brendenwood Dr
Voorhees, NJ 08043-1603

Mailing address

1415 Marlton Pike E Ste LL5
Cherry Hill, NJ 08034-2229
Phone (856) 285-7200

Other identifiers 2

IdentifierTypeStateIssuer
381020OtherNJMEDICARE GROUP
0455091OtherNJMEDICAID GROUP

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
I20050926000239 NJ Practitioner - Internal Medicine 7214961523 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA05198500NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Consensus Medical Group LLC Internal Medicine CurrentSince Apr 1, 2019 Accepting new patients
Marc Feingold MD LLC Current Accepting new patients
Complete Care at Voorhees LLC Past Accepting new patients

Locations

706 Bergen Ave
Ste 2
Jersey City, NJ 07306
Phone (201) 464-8888

420 Bridge Plaza Dr
Manalapan, NJ 07726
Phone (732) 536-8008

402 Lippincott Dr
Marlton, NJ 08053
Phone (410) 763-8787

3 Brendenwood Dr
Voorhees, NJ 08043
Phone (856) 874-0202

Organizations & group practices 4

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": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549843200000",
    "number": "1063573616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 MARLTON PIKE E STE LL5",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080342229",
            "telephone_number": "856-285-7200",
            "fax_number": "856-285-7201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 BRENDENWOOD DR",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080431603",
            "telephone_number": "856-874-0202",
            "fax_number": "856-874-0220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENRIQUEZ",
        "first_name": "EDUARDO",
        "middle_name": "FRANCISCO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2019-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA05198500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "381020",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID GROUP",
            "identifier": "0455091",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Voorhees, NJ

Sources for this page

Verify at the official NPI Registry.