Richard A Renza, DO
Individual provider Active NPI Family Medicine Physician · Wildwood Crest, NJ
NPI 1154477479 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1154477479
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- MB02591800 (NJ)
- Practice address
- 6410 New Jersey Ave
Wildwood Crest, NJ 08260-1216 - Phone
- (609) 523-1331
- Fax
- (609) 522-1516
- NPI assigned
- Jan 27, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 7
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040218000161 | NJ | Practitioner - General Practice |
0446159875 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MB02591800 | NJ | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Atlanticare Physician Group, PA | Current |
Accepting new patients | |
| Cape Regional Urgent Care LLC | Current |
Accepting new patients | |
| Cape Regional Urgent Care LLC | Current |
Accepting new patients | |
| Atlanticare Physician Group | Current |
Accepting new patients | |
| Atlanticare Physician Group PA | Family Medicine | Current | Accepting new patients |
| Richard a Renza DO PA | Family Medicine | Past |
Accepting new patients |
| Cape May County Radiology, PA | Past | Accepting new patients |
Locations
11 Court House South Dennis Rd
Ste 3
Cape May Court House, NJ 08210
Phone (609) 465-6364
459 Route 9 S
Little Egg Harbor Twp, NJ 08087
Phone (609) 340-7815
3826 Bayshore Rd
North Cape May, NJ 08204
Phone (609) 390-9740
406 W Rio Grande Ave
Wildwood, NJ 08260
Phone (609) 465-6364
6410 New Jersey Ave
Wildwood Crst, NJ 08260
Phone (609) 522-1404
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MB02591800 | NJ | Yes |
Addresses
Primary practice location
6410 New Jersey Ave
Wildwood Crest, NJ 08260-1216
Mailing address
PO Box 278
Cape May Court House, NJ 08210-0278
Phone (609) 523-1331
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245503 | Medicaid | NJ |
Other providers in Wildwood Crest, NJ
- John Francis Lewis
- Scott Maslow
- Melissa J Long
- Dawn Paone
- Stacy Phillips
- Richard a Renza DO PA
- Shatkin Cardiology, LLC
- Bennett J Shatkin
- Kimberly Sorensen
All providers in Wildwood Crest, NJ · Family Medicine Physician in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.