NPIMap

Organization Active NPI

Advocare

Doing business as Advocare Medford Station Internal Medicine

  • Internal Medicine Physician
  • Medford, NJ
National Provider Identifier
1326294273
Registry record updated Sep 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
ADVOCARE
Doing business as
Advocare Medford Station Internal Medicine
Practice address
69 N Main St
Medford, NJ 08055-2718
Phone
(609) 953-9000
Fax
(609) 953-9696
NPI assigned
Aug 12, 2008
Last updated
Sep 16, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
ADVOCAREAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 16, 2022

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

Authorized official

Name
Dr. John M. Tedeschi, MDNPI 1194789156
Title
Ceo/ Chairman
Phone
(856) 782-3300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

69 N Main St
Medford, NJ 08055-2718

Mailing address

PO Box 71422
Philadelphia, PA 19176-1422
Phone (856) 872-7055

Other identifiers 1

IdentifierTypeStateIssuer
31D0118747OtherCLIA

Other names 1

  • Advocare Medford Station Internal Medicine Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Advocare LLC250 organizations share this tax ID, including this one
Part of
Advocare LLC

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Practitioners & affiliated clinicians

Practitioners 2

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": "1218499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663286400000",
    "number": "1326294273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 71422",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191761422",
            "telephone_number": "856-872-7055",
            "fax_number": "856-504-8029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69 N MAIN ST",
            "city": "MEDFORD",
            "state": "NJ",
            "postal_code": "080552718",
            "telephone_number": "609-953-9000",
            "fax_number": "609-953-9696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVOCARE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ADVOCARE",
        "enumeration_date": "2008-08-12",
        "last_updated": "2022-09-16",
        "certification_date": "2022-09-16",
        "status": "A",
        "authorized_official_last_name": "TEDESCHI",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "CEO/ CHAIRMAN",
        "authorized_official_telephone_number": "856-782-3300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "31D0118747",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advocare Medford Station Internal Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Advocare Medford Station Internal Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Medford, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.