Esa South Jersey Bariatrics, P.a.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

25MB082666100 Issued in NJ

Legal business name

ESA SOUTH JERSEY BARIATRICS, P.A.

Practice address

1103 West Sherman Avenue
Building 2 Unit C
Vineland, NJ 08360

Phone

(856) 362-5259

Fax

(856) 405-6978

NPI assigned

Oct 5, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Ahmed Farouk Attia, D.O.NPI 1669538740

Title

Physician/Proprietor

Phone

(856) 362-5259

Specialties & licenses 1

Addresses

Other identifiers 8

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 3

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

• Ahmed Farouk Attia, D.O.

  • Surgery Physician
  • Vineland, NJ
  • NPI 1669538740
  Medicare reassignment Care Compare group NPD Authorized official
• Derek Allen Stephenson, M.D.

  • Surgery Physician
  • Vineland, NJ
  • NPI 1740441443
  Medicare reassignment Care Compare group NPD
• Candice Lyn Wasolaskus, R.D.

  • Registered Dietitian
  • Vineland, NJ
  • NPI 1144656604
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1286236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646611200000",
    "number": "1235448564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1103 WEST SHERMAN AVENUE",
            "address_2": "BUILDING 2 UNIT C",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "08360",
            "telephone_number": "856-362-5259",
            "fax_number": "856-407-6978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1103 WEST SHERMAN AVENUE",
            "address_2": "BUILDING 2 UNIT C",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "08360",
            "telephone_number": "856-362-5259",
            "fax_number": "856-405-6978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ESA SOUTH JERSEY BARIATRICS, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-05",
        "last_updated": "2022-03-07",
        "certification_date": "2022-03-07",
        "status": "A",
        "authorized_official_last_name": "ATTIA",
        "authorized_official_first_name": "AHMED",
        "authorized_official_middle_name": "FAROUK",
        "authorized_official_title_or_position": "PHYSICIAN/PROPRIETOR",
        "authorized_official_telephone_number": "856-362-5259",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "NJ",
            "license": "25MB082666100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "2785305",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON NJ HEALTH",
            "identifier": "60072276",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICHOICE-UHC COMMUNITY PLAN",
            "identifier": "01004632800",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "3811510001",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD-UNITED HEALTHCARE",
            "identifier": "P3868269",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HEALTHCARE",
            "identifier": "5974712",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0148911",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH HMO",
            "identifier": "2871684000",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Allison Endicott, PA-C
• Endoscopy Center of South Jersey P C
• Stephanie Mazzoni Engle, LCSW
• Carla Victoria Enriquez, M.D., F.A.A.P.
• Eliza Ermold, OTR/L
• Karan K Estwick, DDS
• Ebony Evans, LPN
• Karl Bruce Evans
• Rashele Evans
• Evernear Healthcare Services LLC

• Surgery Physician in Vineland, NJ
• Providers in Vineland, NJ by specialty
• Surgery Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.