Individual provider Active NPI

Juan Bejaran, MD

  • Internal Medicine Physician
  • Hammonton, NJ
National Provider Identifier
1184730632
Registry record updated Aug 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA06663500 Issued in NJ
Practice address
860 S White Horse Pike
Hammonton, NJ 08037-2018
Phone
(609) 567-0200
Fax
(609) 704-1482
NPI assigned
Aug 21, 2006
Last updated
Aug 29, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MA06663500 NJ Primary

Addresses

Primary practice location

860 S White Horse Pike
Hammonton, NJ 08037-2018

Mailing address

PO Box 1309
Marlton, NJ 08053-6309
Phone (609) 567-0200

Other practice location 1

3003 English Creek Ave Ste C6
Egg Harbor Township, NJ 08234-4818
Phone (609) 481-3185

Other identifiers 1

IdentifierTypeStateIssuer
8056307MedicaidNJ

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
I20100723000145 NJ Practitioner - Internal Medicine 4183756331 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

860 S White Horse Pike
Hammonton, NJ 08037-2018
Phone (609) 567-0200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA06663500NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Jersey Family Medical Centers, Inc CurrentSince Feb 9, 1998 Accepting new patients
Atlanticare Regional Medical Center Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Southern Jersey Family Medical Centers, Inc. PastSince Sep 5, 2023 Accepting new patients

Locations

1125 Atlantic Ave
Atlantic City, NJ 08401
Phone (609) 348-0066

3003 English Creek Ave
Ste C6
Egg Harbor Twp, NJ 08234
Phone (609) 481-3185

1 N White Horse Pike
Hammonton, NJ 08037
Phone (609) 567-0200

860 S White Horse Pike
Hammonton, NJ 08037
Phone (609) 567-0200

Organizations & group practices 4

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.

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": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693267200000",
    "number": "1184730632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1309",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080536309",
            "telephone_number": "609-567-0200",
            "fax_number": "609-704-5615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "860 S WHITE HORSE PIKE",
            "city": "HAMMONTON",
            "state": "NJ",
            "postal_code": "080372018",
            "telephone_number": "609-567-0200",
            "fax_number": "609-704-1482"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3003 English Creek Ave Ste C6",
            "address_purpose": "LOCATION",
            "city": "Egg Harbor Township",
            "state": "NJ",
            "postal_code": "082344818",
            "country_code": "US",
            "telephone_number": "609-481-3185",
            "fax_number": "609-569-0104",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEJARAN",
        "first_name": "JUAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2023-08-29",
        "certification_date": "2023-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA06663500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8056307",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hammonton, NJ

Sources for this page

Verify at the official NPI Registry.