Family Care PA
Organization Active NPI Internal Medicine Physician · Green Brook, NJ
NPI 1275619413 · NPPES record last updated Jun 14, 2012
Key facts
- NPI
- 1275619413
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 25MA05399400 (NJ)
- Legal business name
- FAMILY CARE PA
- Practice address
- 257 RT 22 East
Green Brook, NJ 08812 - Phone
- (732) 968-8832
- Fax
- (732) 968-2187
- NPI assigned
- Oct 31, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. John Nick Chafos, MD
- Title
- Owner Director
- Phone
- (732) 968-8832
Other NPIs on the same Medicare enrollment 1
-
John Nick Chafos, MD
Practitioners 13
-
John Nick Chafos, MD
-
Melvin Chan, NP-C, PHD
-
Ashley L Lake, APN
-
Jaime Lazo Ligot, M.D.
-
Steven Risman, MD
-
Jawaun Wynn, PA-C
-
Jean M Covino, MPA PA C
-
Annmarie R Lambert, P.A.-C
-
Shauna Marie Abel, APN, ACNP-BC
-
Raymond Stanley Briski, M.D.
-
Joseph Atanasio, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NJ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930083895 | NJ | DME Supplier - Physician - General Practice | 1658584008 |
1 other NPI on this enrollment Practice locations: Greenbrook, NJ |
| O20120620000110 | NJ | Part B Supplier - Clinic/Group Practice | 1658584008 |
Receives reassigned benefits from 12 practitioners Practice locations: Green Brook, NJ; Hillsborough, NJ |
National Provider Directory
Locations
256 US Highway 206
Hillsborough, NJ 08844
Phone (908) 262-2263
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician |
207P00000X | 25MA05399400 | NJ | |
| Internal Medicine Physician |
207R00000X | 25MA05399400 | NJ | Yes |
Addresses
Primary practice location
257 RT 22 East
Green Brook, NJ 08812
Mailing address
257 RT 22 East
Green Brook, NJ 08812
Phone (732) 968-8832
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 25MA05399400 | Other | NJ | LICENSE NUMBER |
Other names
- John Chafos MD
Other providers in Green Brook, NJ
- Snehal M Desai
- Anandan Devarajan
- Ellen Rado DDS PC Art of Dental Care
- Jacqueline M Faccone
- Jaime Rose Falco
- Family Care,P.a.
- Allyssa Finer
- Cristiana Formica
- Ronald M. Frank
- Lester Frankel
All providers in Green Brook, NJ · Internal Medicine Physician in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 14, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.