Individual provider Active NPI

Elaine Dennis, M.D.

  • Emergency Medical Services (Emergency Medicine) Physician
  • Howell, NJ
National Provider Identifier
1356368971
Registry record updated Nov 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
License
25MA07164700 Issued in NJ
Practice address
4013 Route 9 N
Howell, NJ 07731-4021
Phone
(732) 905-5255
Fax
(732) 905-5266
NPI assigned
Jul 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD 423829 PA
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 25MA07164700 NJ Primary

Addresses

Primary practice location

4013 Route 9 N
Howell, NJ 07731-4021

Mailing address

17 Casino Dr
Farmingdale, NJ 07727-3701
Phone (732) 938-3580

Other identifiers 1

IdentifierTypeStateIssuer
10110345MedicaidPA

Other names 1

  • Pierro Christie Former name

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
I20040511001209 NJ Practitioner - Emergency Medicine 2466441779 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD 423829PAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Jersey Urgent Care CurrentSince Sep 1, 2016 Accepting new patients
Central Jersey Urgent Care CurrentSince Sep 1, 2016 Accepting new patients
Health Access Network Emergency Medicine Past Accepting new patients
Tidal Emergency Physicians LLC Emergency Medicine Past Accepting new patients

Locations

298 Applegarth Rd
Ste B
Monroe Township, NJ 08831
Phone (609) 409-0600

731 State Route 35
Unit G
Ocean, NJ 07712
Phone (732) 455-8444

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414972800000",
    "number": "1356368971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 CASINO DR",
            "city": "FARMINGDALE",
            "state": "NJ",
            "postal_code": "077273701",
            "telephone_number": "732-938-3580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4013 ROUTE 9 N",
            "city": "HOWELL",
            "state": "NJ",
            "postal_code": "077314021",
            "telephone_number": "732-905-5255",
            "fax_number": "732-905-5266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENNIS",
        "first_name": "ELAINE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2014-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MD 423829",
            "primary": false
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "NJ",
            "license": "25MA07164700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10110345",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PIERRO",
            "last_name": "CHRISTIE",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Howell, NJ

Sources for this page

Verify at the official NPI Registry.