Individual provider Active NPI

Elham M Ismail, MD

  • Internal Medicine Physician
  • Bridgeton, NJ
National Provider Identifier
1225057276
Registry record updated Mar 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2267101 Issued in NY
Practice address
70 Cohansey St
Bridgeton, NJ 08302-1918
Phone
(856) 451-4700
Fax
(856) 863-5732
NPI assigned
Jul 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2012

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 2267101 NY Primary

Addresses

Primary practice location

70 Cohansey St
Bridgeton, NJ 08302-1918

Mailing address

53 S Laurel St
Second Floor
Bridgeton, NJ 08302-1946
Phone (856) 451-4700

Other identifiers 1

IdentifierTypeStateIssuer
172369822MedicaidNY

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
I20080305000429 NJ Practitioner - Internal Medicine 8820042351 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Health Care, Inc.Group PAC ID 9335040419, 126 clinicians

Practice addresses (Care Compare)

335 Delsea Dr N
Glassboro, NJ 08028-1403
Phone 85645147002755

3700 New Jersey Ave
Wildwood, NJ 08260-6154
Phone (856) 451-4700

785 W Sherman Ave
Vineland, NJ 08360-6913
Phone (856) 451-4700

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2267101NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Care, Inc. Internal Medicine CurrentSince Jan 1, 2008 Accepting new patients
Community Health Care, Inc. CurrentSince Jan 1, 2008 Accepting new patients
The Cooper Health System Past Accepting new patients
Inspira Medical Centers, Inc. Past Accepting new patients
Inspira Medical Centers, Inc. Past Accepting new patients

Locations

70 Cohansey St
Bridgeton, NJ 08302
Phone (856) 497-6650

53 S Laurel St
#2
Bridgeton, NJ 08302

30 N Pearl St
Bridgeton, NJ 08302

335 Delsea Dr N
Glassboro, NJ 08028
Phone (856) 863-5720

1505 W Sherman Ave
Vineland, NJ 08360
Phone (856) 451-6600

Interoperability endpoints

  • Direct secure messaging: elham.ismail.p1@direct.cchn.nextgenshare.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330560000000",
    "number": "1225057276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 S LAUREL ST",
            "address_2": "SECOND FLOOR",
            "city": "BRIDGETON",
            "state": "NJ",
            "postal_code": "083021946",
            "telephone_number": "856-451-4700",
            "fax_number": "856-863-5732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 COHANSEY ST",
            "city": "BRIDGETON",
            "state": "NJ",
            "postal_code": "083021918",
            "telephone_number": "856-451-4700",
            "fax_number": "856-863-5732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISMAIL",
        "first_name": "ELHAM",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2012-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "2267101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "172369822",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeton, NJ

Sources for this page

Verify at the official NPI Registry.