NPIMap

Organization Active NPI

South Jersey Gastroenterology PA

  • Anesthesiology Physician
  • Voorhees, NJ
National Provider Identifier
1356514335
Registry record updated Sep 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
SOUTH JERSEY GASTROENTEROLOGY PA
Practice address
93 Cooper Rd
Suite 100
Voorhees, NJ 08043-4910
Phone
(856) 770-1920
Fax
(856) 770-1925
NPI assigned
Apr 10, 2008
Last updated
Sep 11, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
SOUTH JERSEY GASTROENTEROLOGY PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 11, 2013

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

Authorized official

Name
Dr. Steven Liakos, D.O.NPI 1295713212
Title
President
Phone
(856) 983-1900

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
Anesthesiology Physician 207L00000X NU Primary

Addresses

Primary practice location

93 Cooper Rd
Suite 100
Voorhees, NJ 08043-4910

Mailing address

406 Lippincott Dr
Suite E
Marlton, NJ 08053-4168
Phone (856) 983-1900

Other names 1

  • Anesthesia Services Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071219000019 NJ Part B Supplier - Clinic/Group Practice 5890885586 Receives reassigned benefits from 2 practitioners
1 other NPI on this enrollment
Practice locations: Voorhees, NJ

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
S Jersey Gastro PA

Locations

501 5th St
Ste 2
Atco, NJ 08004

1803 Springdale Rd
Cherry Hill, NJ 08003
Phone (609) 424-4339

858 S White Horse Pike
Ste B2
Hammonton, NJ 08037
Phone (609) 561-2345

117 E Laurel Rd
Stratford, NJ 08084
Phone (856) 346-4048

93 Cooper Rd
Voorhees, NJ 08043
Phone (856) 767-3435

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 11

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": "1207785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378857600000",
    "number": "1356514335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 LIPPINCOTT DR",
            "address_2": "SUITE E",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080534168",
            "telephone_number": "856-983-1900",
            "fax_number": "856-983-1914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "93 COOPER RD",
            "address_2": "SUITE 100",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080434910",
            "telephone_number": "856-770-1920",
            "fax_number": "856-770-1925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH JERSEY GASTROENTEROLOGY PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTH JERSEY GASTROENTEROLOGY PA",
        "enumeration_date": "2008-04-10",
        "last_updated": "2013-09-11",
        "status": "A",
        "authorized_official_last_name": "LIAKOS",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "856-983-1900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Anesthesia Services",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Voorhees, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.