Individual provider Active NPI

Hani Batarseh, MD

  • Internal Medicine Physician
  • South Amboy, NJ
National Provider Identifier
1114907557
Registry record updated Apr 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MA072459 Issued in NJ
Practice address
540 Bordentown Ave
Suite 2100
South Amboy, NJ 08879-1544
Phone
(732) 721-1500
NPI assigned
Jan 20, 2006
Last updated
Apr 9, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2008

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 MA072459 NJ Primary

Addresses

Primary practice location

540 Bordentown Ave
Suite 2100
South Amboy, NJ 08879-1544

Mailing address

540 Bordentown Ave
Suite 2100
South Amboy, NJ 08879-1544
Phone (732) 721-1500

Other identifiers 1

IdentifierTypeStateIssuer
8889007MedicaidNJ

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
I20031218000302 NJ Practitioner - Internal Medicine 4981501707 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

540 Bordentown Ave
Suite 2100
South Amboy, NJ 08879-1583
Phone (732) 721-1500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA072459NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Batarseh Walk in Medical Center, LLC. Internal Medicine CurrentSince May 25, 2010 Accepting new patients
Michael J Kassouf, MD.,PC Past Accepting new patients
Kivarkis Y Younan MD PA Internal Medicine PastSince Sep 1, 2016 Accepting new patients
Longevity Medical LLC Past Accepting new patients

Locations

540 Bordentown Ave
Ste 2100
South Amboy, NJ 08879
Phone (732) 553-1555

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1137715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207699200000",
    "number": "1114907557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 BORDENTOWN AVE",
            "address_2": "SUITE 2100",
            "city": "SOUTH AMBOY",
            "state": "NJ",
            "postal_code": "088791544",
            "telephone_number": "732-721-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 BORDENTOWN AVE",
            "address_2": "SUITE 2100",
            "city": "SOUTH AMBOY",
            "state": "NJ",
            "postal_code": "088791544",
            "telephone_number": "732-721-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BATARSEH",
        "first_name": "HANI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-20",
        "last_updated": "2008-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "MA072459",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8889007",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Amboy, NJ

Sources for this page

Verify at the official NPI Registry.