Individual provider Active NPI

Phillip Charles Feliciano, MD

  • Family Medicine Physician
  • Atlantic City, NJ
National Provider Identifier
1174029110
Registry record updated Apr 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MA13046600 Issued in NJ
Practice address
7 S Ohio Ave Ste 2100
Atlantic City, NJ 08401-6711
Phone
(609) 572-8800
NPI assigned
Mar 30, 2018
Last updated
Apr 7, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25MA13046600 NJ Primary
Family Medicine Physician 207Q00000X A201537 CA

Addresses

Primary practice location

7 S Ohio Ave Ste 2100
Atlantic City, NJ 08401-6711

Mailing address

7 S Ohio Ave Ste 2100
Atlantic City, NJ 08401-6711
Phone (609) 572-8800

Other practice location 1

14850 Roscoe Blvd
Panorama City, CA 91402-4677
Phone (818) 787-2222

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
I20260505004024 NJ Practitioner - Family Practice 7810465127 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

7 S Ohio Ave
Suite 2100
Atlantic City, NJ 08401-6711
Phone (609) 572-8800

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A201537CAMDFamily Medicine Physician
25MA13046600NJMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Atlanticare Health Services, Inc. CurrentSince Apr 22, 2026 Accepting new patients
Atlanticare Health Services, Inc. PastSince Apr 22, 2026 Accepting new patients

Locations

7 S Ohio Ave
Ste 2100
Atlantic City, NJ 08401
Phone (609) 441-8146

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1522368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775520000000",
    "number": "1174029110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 S OHIO AVE STE 2100",
            "city": "ATLANTIC CITY",
            "state": "NJ",
            "postal_code": "084016711",
            "telephone_number": "609-572-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 S OHIO AVE STE 2100",
            "city": "ATLANTIC CITY",
            "state": "NJ",
            "postal_code": "084016711",
            "telephone_number": "609-572-8800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14850 Roscoe Blvd",
            "address_purpose": "LOCATION",
            "city": "Panorama City",
            "state": "CA",
            "postal_code": "914024677",
            "country_code": "US",
            "telephone_number": "818-787-2222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FELICIANO",
        "first_name": "PHILLIP",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-30",
        "last_updated": "2026-04-07",
        "certification_date": "2026-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA13046600",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A201537",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlantic City, NJ

Sources for this page

Verify at the official NPI Registry.