Individual provider Active NPI

Craig M. Wax, D.O.

  • Family Medicine Physician
  • Mullica Hill, NJ
National Provider Identifier
1124072285
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MB62553 Issued in NJ
Practice address
155 N Main St
Mullica Hill, NJ 08062-2612
Phone
(856) 478-4780
NPI assigned
May 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MB62553 NJ Primary

Addresses

Primary practice location

155 N Main St
Mullica Hill, NJ 08062-2612

Mailing address

155 N Main St
Mullica Hill, NJ 08062-2612

Other names 1

  • None None None Other name

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
I20070123000329 NJ Practitioner - Family PracticePractitioner - Osteopathic Manipulative Medicine 1557362209 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Osteopathic Manipulative Medicine
Education
New York College of Osteo Medicine of New York Institute of Technology, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

155 N Main St
Mullica Hill, NJ 08062-2612
Phone (856) 478-4780

Hospital & facility affiliations

  • Bayada at Inspira, Home Health and Hospice Home health agency, Millville, NJ, CCN 317089

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MB62553NJMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Craig M. Wax, DO, LLC Family Medicine CurrentSince Jan 18, 2007 Accepting new patients

Locations

155 N Main St
Mullica Hill, NJ 08062
Phone (856) 478-4780

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124072285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 N MAIN ST",
            "city": "MULLICA HILL",
            "state": "NJ",
            "postal_code": "080622612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 N MAIN ST",
            "city": "MULLICA HILL",
            "state": "NJ",
            "postal_code": "080622612",
            "telephone_number": "856-478-4780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAX",
        "first_name": "CRAIG",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "MB62553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NONE",
            "last_name": "NONE",
            "middle_name": "NONE",
            "credential": "D.O.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Mullica Hill, NJ

Sources for this page

Verify at the official NPI Registry.