Angelic Health Practice Group
Organization Active NPI Family Medicine Physician · Pleasantville, NJ
NPI 1316637838 · NPPES record last updated May 9, 2023
Key facts
- NPI
- 1316637838
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- ANGELIC HEALTH PRACTICE GROUP
- Practice address
- 8025 Black Horse Pike Ste 501
Pleasantville, NJ 08232-2967 - Phone
- (609) 464-1135
- Fax
- (609) 939-1676
- NPI assigned
- May 9, 2023
- Organization subpart
- Yes
- Parent organization (as reported)
- ANGELIC HEALTH PRACTICE GROUP
Authorized official
- Name
- Dan Mikus
- Title
- Ceo
- Phone
- (609) 822-7979
Other NPIs on the same Medicare enrollment 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240123001751 | NJ | Part B Supplier - Clinic/Group Practice | 9537510938 |
Receives reassigned benefits from 8 practitioners 4 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Pleasantville, NJ |
National Provider Directory
- Part of
- Angelic Palliative Care PA
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
8025 Black Horse Pike Ste 501
Pleasantville, NJ 08232-2967
Mailing address
8025 Black Horse Pike Ste 501
Pleasantville, NJ 08232-2967
Phone (609) 464-1135
Other names
- Angelic Post Acute
Other providers in Pleasantville, NJ
- Sujood Ahmed
- Babatunde A. Ajayi
- Always Young at Heart LLP
- Karen Amelung
- Cathy Anderson
- Angelic Health Practice Group
- Angelic Health Practice Group
- Angelic Health Practice Group
- Angelic Health Practice Group
- Angelic Palliative Care
All providers in Pleasantville, NJ · Family 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 May 9, 2023. 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.