NPIMap

Organization Active NPI

Ocean Health Initiatives, Inc

  • Federally Qualified Health Center (FQHC)
  • Toms River, NJ
National Provider Identifier
1417938044
Registry record updated Mar 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
23453 Issued in NJ
Legal business name
OCEAN HEALTH INITIATIVES, INC
Practice address
10 Stockton Drive
Toms River, NJ 08755
Phone
(732) 363-6655
Fax
(732) 552-0378
NPI assigned
Nov 10, 2005
Last updated
Mar 29, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2019

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

Authorized official

Name
Theresa Berger, MD
Title
Ceo
Phone
(732) 363-6655

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 23453 NJ Primary

Addresses

Primary practice location

10 Stockton Drive
Toms River, NJ 08755

Mailing address

3600 Route 66
Suite 400
Neptune, NJ 07753
Phone (732) 363-6655

Other identifiers 1

IdentifierTypeStateIssuer
0076244MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040405001022 NJ Part B Supplier - Clinic/Group Practice 2062405277 Receives reassigned benefits from 136 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Toms River, NJ; Little Egg Harbor, NJ; Lakewood, NJ; Freehold, NJ; Clifton, NJ; Brick, NJ
O20240222003201 NJ Part A Provider - Federally Qualified Health Center (FQHC) 2062405277 Practice locations: Toms River, NJ

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1417938044. Details of each certification follow.

Federally qualified health center certification: CCN 311005

Legal name
OCEAN HEALTH INITIATIVES, INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Feb 20, 2024
Last certification
Feb 20, 2024
Ownership / control type
For profit – corporation
Organization structure
OtherNon-profit
Enrollment address
10 Stockton Dr
Toms River, NJ 87556433

Federally qualified health center certification: CCN 311861

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
OCEAN HEALTH INITIATIVES INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 1, 2005
Last certification
Jul 1, 2005
Ownership / control type
For profit – partnership
Facility address
10 Stockton Drive
Toms River, NJ 08755

Other NPIs with the same Medicare PAC ID 9

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 6

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

National Provider Directory

National Provider Directory
Tax ID family
Ocean Health Initatives Inc10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1610 Route 88
Ste 3
Brick, NJ 08724

Ownership & related parties

All disclosed owners & managing parties 12

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Joseph Casello Individual Corporate OfficerBoard Member Jan 31, 2024
Debra Levinson Individual Corporate OfficerBoard Member Jan 31, 2024
Anthony Nicholas Lombardino Individual Corporate OfficerVice Chair Jan 31, 2024
Donald Caruso Individual Corporate OfficerBoard Member Jan 31, 2024
Catherine Ainora Individual Corporate OfficerTreasurer Jan 31, 2024
John Craddox Individual Corporate OfficerBoard Member Jan 31, 2024
Mary Guarin Individual Corporate OfficerBoard Member Jan 31, 2024
Jorge Rod Individual Corporate DirectorChair Jan 31, 2024
Theresa Berger Individual Corporate OfficerBoard Chair Jan 31, 2024
Corporate DirectorCeo Jan 31, 2024 100%
W-2 Managing EmployeeCeo Jan 31, 2024 100%
Maryjo Grauso Individual Corporate OfficerBoard Member Jan 31, 2024
Vincent Della Donna Individual Corporate OfficerBoard Member Jan 31, 2024
Eric Houghtaling Individual Corporate OfficerBoard Member Jan 31, 2024

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 123

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.

View all 123

NPI Registry JSON

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

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553817600000",
    "number": "1417938044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 ROUTE 66",
            "address_2": "SUITE 400",
            "city": "NEPTUNE",
            "state": "NJ",
            "postal_code": "07753",
            "telephone_number": "732-363-6655",
            "fax_number": "732-552-0378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 STOCKTON DRIVE",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "08755",
            "telephone_number": "732-363-6655",
            "fax_number": "732-552-0378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OCEAN HEALTH INITIATIVES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-10",
        "last_updated": "2019-03-29",
        "status": "A",
        "authorized_official_last_name": "BERGER",
        "authorized_official_first_name": "THERESA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "732-363-6655",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NJ",
            "license": "23453",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0076244",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toms River, NJ

Sources for this page

Verify at the official NPI Registry.