NPIMap

Organization Active NPI

Diabetes & Endocrinology Associates of South Jersey PC

  • Endocrinology, Diabetes & Metabolism Physician
  • Hammonton, NJ
National Provider Identifier
1073641429
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
25MA05897300 Issued in NJ
Legal business name
DIABETES & ENDOCRINOLOGY ASSOCIATES OF SOUTH JERSEY PC
Practice address
8 N White Horse Pike Ste 101
Hammonton, NJ 08037-1873
Phone
(609) 704-9100
Fax
(609) 567-3817
NPI assigned
Feb 28, 2007
Last updated
Aug 22, 2020By the provider in NPPES
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. Rishi K. Rastogi, M.D.
Title
President
Phone
(856) 262-4681

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 25MA05897300 NJ Primary

Addresses

Primary practice location

8 N White Horse Pike Ste 101
Hammonton, NJ 08037-1873

Mailing address

512 Stockton Dr
Williamstown, NJ 08094-1984
Phone (856) 262-4681

Other identifiers 1

IdentifierTypeStateIssuer
7520301MedicaidNJ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040717000075 NJ Part B Supplier - Clinic/Group Practice 4880673326 Receives reassigned benefits from 1 practitioner
Practice locations: Vineland, NJ; Hammonton, NJ

National Provider Directory

National Provider Directory
Tax ID family
Diabetes Endocrinology Associates of South Jersey4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

425 12th St
Ste 2
Hammonton, NJ 08037
Phone (609) 561-8855

810 Woodlawn Ave
Hammonton, NJ 08037
Phone (609) 704-9100

10 Lasalle St
Vineland, NJ 08360
Phone (609) 704-9100

2791 S Delsea Dr
Vineland, NJ 08360
Phone (856) 405-0962

65 S State St
Vineland, NJ 08360
Phone (609) 451-9395

Practitioners & affiliated clinicians

Practitioners 10

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": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1073641429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 STOCKTON DR",
            "city": "WILLIAMSTOWN",
            "state": "NJ",
            "postal_code": "080941984",
            "telephone_number": "856-262-4681",
            "fax_number": "856-262-2376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 N WHITE HORSE PIKE STE 101",
            "city": "HAMMONTON",
            "state": "NJ",
            "postal_code": "080371873",
            "telephone_number": "609-704-9100",
            "fax_number": "609-567-3817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIABETES & ENDOCRINOLOGY ASSOCIATES OF SOUTH JERSEY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RASTOGI",
        "authorized_official_first_name": "RISHI",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "856-262-4681",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NJ",
            "license": "25MA05897300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7520301",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hammonton, 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.