NPIMap

Organization Active NPI

Pinnacle Treatment Centers NJ-III, LLC

  • Methadone Clinic
  • Somerdale, NJ
National Provider Identifier
1255059481
Registry record updated Nov 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Methadone ClinicTaxonomy code 261QM2800X
Legal business name
PINNACLE TREATMENT CENTERS NJ-III, LLC
Practice address
1200 S. White Horse Pike
Suites 8,9,10, 11
Somerdale, NJ 08083-1332
Phone
(856) 792-7513
NPI assigned
Aug 15, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2023

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

Authorized official

Name
Robyn Tanis
Title
Executive Director of Contract MGMT
Phone
(856) 533-8762

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Methadone Clinic 261QM2800X Primary
Recovery Care Clinic/Center 261QR0800X

Addresses

Primary practice location

1200 S. White Horse Pike
Suites 8,9,10, 11
Somerdale, NJ 08083-1332

Mailing address

1317 Route 73 Ste 200
Mount Laurel, NJ 08054-2202
Phone (856) 439-6111

Other names 1

  • Somerdale Treatment Services Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Opioid treatment program
Medicare-enrolled since Jan 1, 2020

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200131001378 NJ Part B Supplier - Opioid Treatment Program (Otp) 4284060799 5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Hamilton, NJ; Pennsauken, NJ; Somerdale, NJ; Trenton, NJ; Vineland, NJ

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Pinnacle Trtmnt Ctr NJ III14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

Organizations that report the same tax identification number in the National Provider Directory.

View all 13

Locations

3444 Quakerbridge Rd
Bldg 1A
Hamilton, NJ 08619
Phone (609) 838-9067

1200 S White Horse Pike
Ste 891011
Somerdale, NJ 08083

1200 S White Horse Pike
#8910
Somerdale, NJ 08083
Phone (856) 792-7513

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1660521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699833600000",
    "number": "1255059481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1317 ROUTE 73 STE 200",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080542202",
            "telephone_number": "856-439-6111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 S. WHITE HORSE PIKE",
            "address_2": "SUITES 8,9,10, 11",
            "city": "SOMERDALE",
            "state": "NJ",
            "postal_code": "080831332",
            "telephone_number": "856-792-7513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINNACLE TREATMENT CENTERS NJ-III, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-15",
        "last_updated": "2023-11-13",
        "certification_date": "2023-11-13",
        "status": "A",
        "authorized_official_last_name": "TANIS",
        "authorized_official_first_name": "ROBYN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR OF CONTRACT MGMT",
        "authorized_official_telephone_number": "856-533-8762"
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Recovery Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Somerdale Treatment Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Somerdale Treatment Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Somerdale, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2023; 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.