NPIMap

Individual provider Active NPI

James Charles Damico, DO

  • Internal Medicine Physician
  • Medford, NJ
National Provider Identifier
1457353088
Registry record updated May 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MB64490 Issued in NJ
Practice address
1 Medford Leas
Medford, NJ 08055-2254
Phone
(609) 654-3427
Fax
(609) 654-5519
NPI assigned
Aug 12, 2005
Last updated
May 12, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MB64490 NJ Primary

Addresses

Primary practice location

1 Medford Leas
Medford, NJ 08055-2254

Mailing address

1 Medford Leas
Medford, NJ 08055-2254
Phone (609) 654-3427

Other identifiers 2

IdentifierTypeStateIssuer
7597703MedicaidNJ
527292OtherNJMEDICARE ID

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address james.damico@mlwc.eclincialdirectplus.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100322000537 NJ Practitioner - Internal Medicine 0648270439 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Rowan University School of Osteopathic Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Estaugh T/a Medford LeasGroup PAC ID 6608833512, 4 clinicians

Practice addresses (Care Compare)

1 Medford Leas
Medford, NJ 08055-2254
Phone (609) 654-3397

1 Medford Leas Way
Medford, NJ 08055-2254

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.8 of 100Reported as individual
Quality
84.13
Promoting interoperability
97
Improvement activities
40
Cost
91.2

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MB64490NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Estaugh T/a Medford Leas CurrentSince Mar 9, 2015 Accepting new patients
The Estaugh CurrentSince Mar 9, 2015 Accepting new patients

Locations

1 Medford Leas Way
Medford, NJ 08055
Phone (609) 654-3000

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Medford LeasMedford, NJ, CCN 315144 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 May 13, 2019
May 13, 2019
Caring Hospice of South Jersey, LLCMount Laurel, NJ, CCN 311546 Hospice W-2 Managing Employee Oct 13, 2000

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 2

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 8

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": "1123804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620777600000",
    "number": "1457353088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDFORD LEAS",
            "city": "MEDFORD",
            "state": "NJ",
            "postal_code": "080552254",
            "telephone_number": "609-654-3427",
            "fax_number": "609-654-5519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDFORD LEAS",
            "city": "MEDFORD",
            "state": "NJ",
            "postal_code": "080552254",
            "telephone_number": "609-654-3427",
            "fax_number": "609-654-5519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAMICO",
        "first_name": "JAMES",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-12",
        "last_updated": "2021-05-12",
        "certification_date": "2021-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "MB64490",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7597703",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "527292",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "james.damico@mlwc.eclincialdirectplus.com",
            "affiliation": "N",
            "endpointDescription": "direct messaging address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1 Medford Leas",
            "city": "Medford",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080552254",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Medford, NJ

Sources for this page

Verify at the official NPI Registry.