Deonde R Degennaro, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

25MP00834200 Issued in NJ

Practice address

2315 Route 34
Manasquan, NJ 08736-1444

Phone

(732) 974-0404

Fax

(732) 449-4271

NPI assigned

Jan 25, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Drexel University College of Medicine, 2021

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Hospital & facility affiliations

• Atlanticare Regional Medical Center - City Campus Hospital, Atlantic City, NJ, CCN 310064

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Atlanticare Regional Medical Center

  • Internal Medicine Physician
  • Atlantic City, NJ
  • NPI 1568663250
  Medicare reassignment NPD
• Orthonj LLC

  • Orthopaedic Surgery Physician
  • Somerset, NJ
  • NPI 1720557432
  Medicare reassignment NPD
• Orthonj LLC

  • Durable Medical Equipment & Medical Supplies
  • Galloway, NJ
  • NPI 1487448312
  NPD

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

• Atlanticare Regional Medical Center

  • General Acute Care Hospital
  • Pomona, NJ
  • NPI 1013919315
  Care Compare affiliation

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

{
    "created_epoch": "1706140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733702400000",
    "number": "1437911526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2315 ROUTE 34",
            "city": "MANASQUAN",
            "state": "NJ",
            "postal_code": "087361444",
            "telephone_number": "732-974-0404",
            "fax_number": "732-449-4271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2315 ROUTE 34",
            "city": "MANASQUAN",
            "state": "NJ",
            "postal_code": "087361444",
            "telephone_number": "732-974-0404",
            "fax_number": "732-449-4271"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "457 Jack Martin Blvd # 08724",
            "address_purpose": "LOCATION",
            "city": "Brick",
            "state": "NJ",
            "postal_code": "087247776",
            "country_code": "US",
            "telephone_number": "732-800-9000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEGENNARO",
        "first_name": "DEONDE",
        "middle_name": "R",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-25",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00834200",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NJ",
            "license": "25MP00834200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel a Walenjus DDS PA
• David Cheli MD PA
• Jamie T Davison-Ortiz
• Craig J Davitt, PA-C
• Riley Defeis, DPT
• Maureen Whelan Dejacimo, OTR
• Gustavo Delaluz, MD
• Katherine Delorenzo, DPT
• Frederick A Depaola, M.D.
• Amy Marie Derrick, APN

• Surgical Physician Assistant in Manasquan, NJ
• Providers in Manasquan, NJ by specialty
• Surgical Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.