Individual provider Active NPI

Colin Peters Jr., D.O.

  • Pulmonary Disease Physician
  • Galloway, NJ
National Provider Identifier
1376077693
Registry record updated Oct 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
25MB12188500 Issued in NJ
Practice address
318 Chris Gaupp Dr
Galloway, NJ 08205-4460
Phone
(609) 748-7300
Fax
(609) 748-7919
NPI assigned
Apr 13, 2017
Last updated
Oct 8, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MB12188500 NJ
Internal Medicine Physician 207R00000X OT017582 PA
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 25MB12188500 NJ
Pulmonary Disease Physician 207RP1001X 25MB12188500 NJ Primary

Addresses

Primary practice location

318 Chris Gaupp Dr
Galloway, NJ 08205-4460

Mailing address

PO Box 13579
Reading, PA 19612-3579

Other practice location 1

420 S 5th Ave
West Reading, PA 19611-2143
Phone (484) 628-8640

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
I20241007000144 NJ Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 4284903154 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists)
Education
Philadelphia College of Osteopathic Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Atlanticare Physician Group PAGroup PAC ID 8527953660, 506 clinicians

Practice addresses (Care Compare)

1401 Atlantic Ave
Suite 2600
Atlantic City, NJ 08401-7027
Phone (609) 572-6055

318 Chris Gaupp Dr
Galloway, NJ 08205-4460
Phone (609) 404-9900

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.34 of 100Reported as apm
Quality
79.77
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MB12188500NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Atlanticare Physician Group, PA CurrentSince Aug 25, 2024 Accepting new patients
Atlanticare Physician Group PA CurrentSince Aug 25, 2024 Accepting new patients
Atlanticare Health Services, Inc. Current Accepting new patients
Atlanticare Health Services, Inc. CurrentSince Oct 1, 2024 Accepting new patients
Atlanticare Health Services, Inc. CurrentSince Oct 1, 2024 Accepting new patients
Atlanticare Health Services Inc. Past Accepting new patients
Atlanticare Physician Group Past Accepting new patients

Locations

1401 Atlantic Ave
Ste 2600
Atlantic City, NJ 08401
Phone (609) 441-8036

2500 English Creek Ave
Ste 200
Egg Harbor Township, NJ 08234
Phone (609) 407-2243

2500 English Creek Ave
Ste 211
Egg Harbor Twp, NJ 08234
Phone (609) 677-6000

6550 Delilah Rd
Ste 301
Egg Hbr Twp, NJ 08234
Phone (609) 573-1251

318 Chris Gaupp Dr
Galloway, NJ 08205
Phone (609) 404-9900

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

Organizations & group practices 7

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1492041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1376077693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13579",
            "city": "READING",
            "state": "PA",
            "postal_code": "196123579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "318 CHRIS GAUPP DR",
            "city": "GALLOWAY",
            "state": "NJ",
            "postal_code": "082054460",
            "telephone_number": "609-748-7300",
            "fax_number": "609-748-7919"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "420 S 5th Ave",
            "address_purpose": "LOCATION",
            "city": "West Reading",
            "state": "PA",
            "postal_code": "196112143",
            "country_code": "US",
            "telephone_number": "484-628-8640",
            "fax_number": "484-628-9003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERS",
        "first_name": "COLIN",
        "name_suffix": "Jr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-13",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MB12188500",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OT017582",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "NJ",
            "license": "25MB12188500",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NJ",
            "license": "25MB12188500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Galloway, NJ

Sources for this page

Verify at the official NPI Registry.