NPIMap

Organization Active NPI

NJ Regional Ear Nose & Throat Center LLC

  • Otolaryngology Physician
  • Manahawkin, NJ
National Provider Identifier
1063591022
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
NJ REGIONAL EAR NOSE & THROAT CENTER LLC
Practice address
1145 Beacon Avenue
Manahawkin, NJ 08050-2626
Phone
(609) 597-7110
Fax
(609) 597-9113
NPI assigned
Nov 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Edward I Engle, DONPI 1417021627
Title
Practice Owner
Phone
(609) 597-7110

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Y00000X Primary

Addresses

Primary practice location

1145 Beacon Avenue
Manahawkin, NJ 08050-2626

Mailing address

1145 Beacon Avenue
Manahawkin, NJ 08050-2626
Phone (609) 597-7110

Other identifiers 4

IdentifierTypeStateIssuer
0081299MedicaidNJ
8222873OtherGHI
103892OtherLOCAL 825
2411865000OtherNJAMERIHEALTH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050509000130 NJ Part B Supplier - Clinic/Group Practice 0244270304 Receives reassigned benefits from 7 practitioners
Practice locations: Manahawkin, NJ; Toms River, NJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1063591022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1145 BEACON AVENUE",
            "city": "MANAHAWKIN",
            "state": "NJ",
            "postal_code": "080502626",
            "telephone_number": "609-597-7110",
            "fax_number": "609-597-9113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1145 BEACON AVENUE",
            "city": "MANAHAWKIN",
            "state": "NJ",
            "postal_code": "080502626",
            "telephone_number": "609-597-7110",
            "fax_number": "609-597-9113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NJ REGIONAL EAR NOSE & THROAT CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ENGLE",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "PRACTICE OWNER",
        "authorized_official_telephone_number": "609-597-7110",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0081299",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "8222873",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LOCAL 825",
            "identifier": "103892",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "2411865000",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manahawkin, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.