NPIMap

Organization Active NPI

Atlanticare Health Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Atlantic City, NJ
National Provider Identifier
1265200190
Registry record updated Jan 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
ATLANTICARE HEALTH SERVICES, INC.
Practice address
7 S Ohio Ave Ste 1100
Atlantic City, NJ 08401-6711
Phone
(609) 572-8666
Fax
(609) 572-8668
NPI assigned
Dec 20, 2023
Last updated
Jan 30, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
ATLANTICARE HEALTH SERVICES, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 30, 2024

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

Authorized official

Name
Mr. Christopher Carl Apgar
Title
Director of Finance
Phone
(609) 572-6006

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X NU
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

7 S Ohio Ave Ste 1100
Atlantic City, NJ 08401-6711

Mailing address

1401 Atlantic Ave Ste 1125
Atlantic City, NJ 08401-7001
Phone (609) 572-6006

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040719001204 NJ Part B Supplier - Clinic/Group Practice 7911810916 Receives reassigned benefits from 105 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Pleasantville, NJ; Galloway, NJ; Egg Harbor Township, NJ; Atlantic City, NJ
O20240612001016 NJ Part A Provider - Federally Qualified Health Center (FQHC) 7911810916 Practice locations: Atlantic City, NJ

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1265200190. Details of each certification follow.

Federally qualified health center certification: CCN 311012

Legal name
ATLANTICARE HEALTH SERVICES, INC.
Doing business as
ATLANTICARE HEALTH SERVICES
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jun 10, 2024
Last certification
Jun 10, 2024
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Oct 14, 1993 in NJ
Enrollment address
7 S Ohio Ave
Ste 1100
Atlantic City, NJ 84016711

Other NPIs with the same Medicare PAC ID 8

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 9

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

National Provider Directory

National Provider Directory
Tax ID family
Atlanticare Surgery Cen16 organizations share this tax ID, including this one
Part of
Atlanticare Surgery Cen

Other organizations with this tax ID 15

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

View all 15

Locations

1401 Atlantic Ave
Ste 1600
Atlantic City, NJ 08401
Phone (609) 572-8555

7 S Ohio Ave
Ste 1100
Atlantic City, NJ 08401
Phone (609) 572-8666

Ownership & related parties

All disclosed owners & managing parties 12

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Ronald Caplan Individual Corporate OfficerTrustee Dec 15, 2016
Jerrold H Savoy Individual Corporate OfficerTrustee May 20, 2020
Shantia Murphy Individual Corporate OfficerTrustee Dec 6, 2023
Rosalind Kincaid Individual Corporate OfficerChairperson Dec 15, 2016
Celestine Perry Individual Corporate DirectorTrustee Dec 15, 2016
Jose Claro Individual Corporate OfficerTrustee Dec 15, 2016
Christian Ragland Individual Corporate OfficerTrustee Feb 15, 2021
Walter Stein Individual Corporate OfficerTrustee Jan 17, 2018
Denisse Ponton Individual Corporate OfficerTrustee Sep 21, 2022
Sandra L Festa Individual Operational/Managerial ControlCeo Jan 22, 2017
Linda Peyton Individual Corporate OfficerTrustee Nov 16, 2022
Blair a Bergen Individual Corporate OfficerTrustee Mar 15, 2023

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 6

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Select Specialty Hospital -Atlantic CityAtlantic City, NJ, CCN 312023 Hospital 5% Or Greater Direct Ownership Interest (20%)
Limited Partnership Interest (20%)		 Apr 2, 2011
Aug 1, 2009
Atlanticare Health Services, Inc.Atlantic City, NJ, CCN 311008 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2023
Atlanticare Health Services, Inc.Atlantic City, NJ, CCN 311009 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2023
Atlanticare Health Services, Inc.Pleasantville, NJ, CCN 311014 Federally qualified health center Operational/Managerial Control (100%) Jun 1, 2024
Atlanticare Health Services, Inc.Atlantic City, NJ, CCN 311015 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Nov 18, 2022
Atlanticare Health Services, Inc.Egg Harbor Township, NJ, CCN 311017 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2023

Owned or controlled facilities with NPI records 6

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1703030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706572800000",
    "number": "1265200190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 ATLANTIC AVE STE 1125",
            "city": "ATLANTIC CITY",
            "state": "NJ",
            "postal_code": "084017001",
            "telephone_number": "609-572-6006",
            "fax_number": "609-572-6001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 S OHIO AVE STE 1100",
            "city": "ATLANTIC CITY",
            "state": "NJ",
            "postal_code": "084016711",
            "telephone_number": "609-572-8666",
            "fax_number": "609-572-8668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTICARE HEALTH SERVICES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ATLANTICARE HEALTH SERVICES, INC.",
        "enumeration_date": "2023-12-20",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A",
        "authorized_official_last_name": "APGAR",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "CARL",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "609-572-6006",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlantic City, NJ

Sources for this page

Verify at the official NPI Registry.