NPIMap

Organization Active NPI

Tabernacle Family Physicians LLC

Doing business as Tabernacle Family Medicine

  • Health Service Clinic/Center
  • Tabernacle, NJ
National Provider Identifier
1437203874
Registry record updated Sep 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
Legal business name
TABERNACLE FAMILY PHYSICIANS LLC
Doing business as
Tabernacle Family Medicine
Practice address
1529 Route 206
Suite L
Tabernacle, NJ 08088-8801
Phone
(609) 268-0707
Fax
(609) 268-7191
NPI assigned
Jan 23, 2007
Last updated
Sep 10, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2008

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

Authorized official

Name
Dr. Parag S Patel, MDNPI 1689751646
Title
Partner
Phone
(609) 268-0707

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X Primary

Addresses

Primary practice location

1529 Route 206
Suite L
Tabernacle, NJ 08088-8801

Mailing address

1529 Route 206
Suite L
Tabernacle, NJ 08088-8801
Phone (609) 268-0707

Other names 1

  • Tabernacle Family Medicine Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070430000523 NJ Part B Supplier - Clinic/Group Practice 0547366064 Receives reassigned benefits from 5 practitioners
Practice locations: Tabernacle, NJ; Marlton, NJ

National Provider Directory

National Provider Directory

Locations

1531 Route 206
Tabernacle, NJ 08088
Phone (609) 268-0707

Practitioners & affiliated clinicians

Practitioners 8

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": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221004800000",
    "number": "1437203874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1529 ROUTE 206",
            "address_2": "SUITE L",
            "city": "TABERNACLE",
            "state": "NJ",
            "postal_code": "080888801",
            "telephone_number": "609-268-0707",
            "fax_number": "609-268-7191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1529 ROUTE 206",
            "address_2": "SUITE L",
            "city": "TABERNACLE",
            "state": "NJ",
            "postal_code": "080888801",
            "telephone_number": "609-268-0707",
            "fax_number": "609-268-7191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TABERNACLE FAMILY PHYSICIANS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2008-09-10",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "PARAG",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "609-268-0707",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tabernacle Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tabernacle, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2008; 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.