NPIMap

Organization Active NPI

Emergency Physician Associates of South Jersey P C

  • Emergency Medicine Physician
  • Voorhees, NJ
National Provider Identifier
1215965231
Registry record updated May 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
EMERGENCY PHYSICIAN ASSOCIATES OF SOUTH JERSEY P C
Practice address
101 Carnie Blvd
Voorhees, NJ 08043-1548
Phone
(856) 686-4300
NPI assigned
Jun 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 2022

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

Authorized official

Name
David Istvan, MDNPI 1467473892
Title
President
Phone
(856) 686-4300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207P00000X Primary

Addresses

Primary practice location

101 Carnie Blvd
Voorhees, NJ 08043-1548

Mailing address

307 S Evergreen Ave
Woodbury, NJ 08096-2739
Phone (856) 686-4316

Other identifiers 10

IdentifierTypeStateIssuer
3440508MedicaidNJ
3151000MedicaidNJ
3384608MedicaidNJ
3151107MedicaidNJ
3440605MedicaidNJ
0090361MedicaidNJ
3384705MedicaidNJ
3384802MedicaidNJ
3431509MedicaidNJ
3440800MedicaidNJ

Other names 1

  • Virtua Health Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040824001263 NJ Part B Supplier - Clinic/Group Practice 5294648457 Receives reassigned benefits from 391 practitioners
Practice locations: Willingboro, NJ; Voorhees, NJ; Turnersville, NJ; Stratford, NJ; Cherry Hill, NJ; Camden, NJ; Berlin, NJ; Marlton, NJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 473

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 473

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653609600000",
    "number": "1215965231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 S EVERGREEN AVE",
            "city": "WOODBURY",
            "state": "NJ",
            "postal_code": "080962739",
            "telephone_number": "856-686-4316",
            "fax_number": "865-291-3254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 CARNIE BLVD",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080431548",
            "telephone_number": "856-686-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERGENCY PHYSICIAN ASSOCIATES OF SOUTH JERSEY P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-29",
        "last_updated": "2022-05-27",
        "certification_date": "2022-05-27",
        "status": "A",
        "authorized_official_last_name": "ISTVAN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "856-686-4300",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3440508",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3151000",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3384608",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3151107",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3440605",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0090361",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3384705",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3384802",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3431509",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3440800",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Virtua Health",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Voorhees, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2022; 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.