NPIMap

Organization Active NPI

Atlantic Emergency Associates, PA

  • Emergency Medicine Physician
  • Atlantic City, NJ
National Provider Identifier
1124112768
Registry record updated Feb 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
ATLANTIC EMERGENCY ASSOCIATES, PA
Practice address
1925 Pacific Avenue
Atlantic City, NJ 08401
Phone
(609) 345-4000
NPI assigned
Oct 3, 2006
Last updated
Feb 2, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2023

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

Authorized official

Name
Stephen Walsh
Title
Busines Manager
Phone
(610) 639-2747

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X Primary

Addresses

Primary practice location

1925 Pacific Avenue
Atlantic City, NJ 08401

Mailing address

PO Box 411020
Boston, MA 02241-1020
Phone (610) 639-2747

Other identifiers 10

IdentifierTypeStateIssuer
611602900OtherNJFECA
611602900OtherNJENERGY
30027297OtherNJKEYSTONE MERCY
36829OtherNJHEALTH PARTNERS
91001879600OtherNJAMERICHOICE
0075141MedicaidNJ
2639764000OtherNJAMERIHEALTH
60018386OtherNJHORIZON NJ HEALTH
611602900OtherNJBLACK LUNG
1105322OtherNJAETNA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050912000320 NJ Part B Supplier - Clinic/Group Practice 1153354170 Receives reassigned benefits from 49 practitioners
Practice locations: Atlantic City, NJ; Pomona, NJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 73

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.

View all 73

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675296000000",
    "number": "1124112768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 411020",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022411020",
            "telephone_number": "610-639-2747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1925 PACIFIC AVENUE",
            "city": "ATLANTIC CITY",
            "state": "NJ",
            "postal_code": "08401",
            "telephone_number": "609-345-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTIC EMERGENCY ASSOCIATES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A",
        "authorized_official_last_name": "WALSH",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "BUSINES MANAGER",
        "authorized_official_telephone_number": "610-639-2747"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FECA",
            "identifier": "611602900",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ENERGY",
            "identifier": "611602900",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE MERCY",
            "identifier": "30027297",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "36829",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICHOICE",
            "identifier": "91001879600",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0075141",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "2639764000",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON NJ HEALTH",
            "identifier": "60018386",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLACK LUNG",
            "identifier": "611602900",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "1105322",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlantic City, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2023; 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.