Individual provider Active NPI

Harry L Chaikin, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Brigantine, NJ
National Provider Identifier
1336139484
Registry record updated Mar 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
25MA03818700 Issued in NJ
Practice address
3400 Brigantine Blvd
Brigantine, NJ 08203-1053
Phone
(609) 266-7557
Fax
(609) 266-4450
NPI assigned
Oct 28, 2005
Last updated
Mar 25, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 25MA03818700 NJ Primary

Addresses

Primary practice location

3400 Brigantine Blvd
Brigantine, NJ 08203-1053

Mailing address

353 12TH St S
Brigantine, NJ 08203-2211
Phone (609) 266-7557

Other practice location 1

353 12th St S
Brigantine, NJ 08203-2211
Phone (609) 266-7557

Other identifiers 1

IdentifierTypeStateIssuer
1166409MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100909000334 NJ Practitioner - Internal MedicinePractitioner - Geriatric Medicine 4284722786 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA03818700NJMDGeriatric Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Atlanticare Physician Group, PA CurrentSince May 29, 2012 Accepting new patients
Atlanticare Physician Group PA Current Accepting new patients
Brigantine Medical Group PA CurrentSince Jul 1, 1981 Accepting new patients
Atlanticare Physician Group CurrentSince May 29, 2012 Accepting new patients

Locations

353 12th St S
Brigantine, NJ 08203
Phone (609) 266-7557

2500 English Creek Ave
Ste 602
Egg Harbor Twp, NJ 08234
Phone (609) 272-6340

459 Route 9 S
Little Egg Harbor Twp, NJ 08087
Phone (609) 340-7815

61 W Jimmie Leeds Rd
Pomona, NJ 08240
Phone (609) 748-5380

Interoperability endpoints

  • Direct secure messaging: harry.chaikin.1@15449.direct.athenahealth.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1130457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553472000000",
    "number": "1336139484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "353 12TH ST S",
            "city": "BRIGANTINE",
            "state": "NJ",
            "postal_code": "082032211",
            "telephone_number": "609-266-7557",
            "fax_number": "609-266-4450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 BRIGANTINE BLVD",
            "city": "BRIGANTINE",
            "state": "NJ",
            "postal_code": "082031053",
            "telephone_number": "609-266-7557",
            "fax_number": "609-266-4450"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "353 12th St S",
            "address_purpose": "LOCATION",
            "city": "Brigantine",
            "state": "NJ",
            "postal_code": "082032211",
            "country_code": "US",
            "telephone_number": "609-266-7557",
            "fax_number": "609-266-4450",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAIKIN",
        "first_name": "HARRY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-28",
        "last_updated": "2019-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NJ",
            "license": "25MA03818700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1166409",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brigantine, NJ

Sources for this page

Verify at the official NPI Registry.