Atlantic Primary Care PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

25MA08110600 Issued in NJ

Legal business name

ATLANTIC PRIMARY CARE PC

Practice address

72 W Jimmie Leeds Rd
Suite 2100
Galloway, NJ 08205-9406

Phone

(609) 652-1115

Fax

(609) 652-1145

NPI assigned

Jul 3, 2008

Last updated

Dec 4, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Vivkekkumar V Dasondi, MD

Title

Owner

Phone

(609) 652-1115

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/GDEGAA

Practitioners 2

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.

• Vivekkumar V Dasondi, MD

  • Internal Medicine Physician
  • Galloway, NJ
  • NPI 1528129509
  Medicare reassignment NPD
• Lisa Kern, APN-C

  • Nurse Practitioner
  • Galloway, NJ
  • NPI 1104989961
  Medicare reassignment NPD

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

{
    "created_epoch": "1215043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354579200000",
    "number": "1174786842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 195",
            "city": "NORTHFIELD",
            "state": "NJ",
            "postal_code": "082250195",
            "telephone_number": "609-926-6900",
            "fax_number": "609-926-6995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72 W JIMMIE LEEDS RD",
            "address_2": "SUITE 2100",
            "city": "GALLOWAY",
            "state": "NJ",
            "postal_code": "082059406",
            "telephone_number": "609-652-1115",
            "fax_number": "609-652-1145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTIC PRIMARY CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-03",
        "last_updated": "2012-12-04",
        "status": "A",
        "authorized_official_last_name": "DASONDI",
        "authorized_official_first_name": "VIVKEKKUMAR",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "609-652-1115",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA08110600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Atlantic Pain and Physical Medicine PC
• Atlantic Pulmonary & Critical Care Associates PA
• Atlantic Regional Cancer Center, LLC
• Atlantic Sleep Health Diagnostic Associates LLC
• Atlanticare Behavioral Health, Inc
• Atlanticare Health Services Inc. (AtlantiCare Mission Health Care Galloway)

• Internal Medicine Physician in Galloway, NJ
• Providers in Galloway, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2012; 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.