NPIMap

Individual provider Active NPI

Richard G Fernicola, MD

  • Rehabilitation Practitioner
  • Brick, NJ
National Provider Identifier
1487723615
Registry record updated Feb 18, 2010
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Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PractitionerTaxonomy code 225400000X
License
MA060824 Issued in NJ
Practice address
1451 Route 88
Suite 5
Brick, NJ 08724-2371
Phone
(732) 660-0202
Fax
(732) 660-0233
NPI assigned
Nov 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 18, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Practitioner 225400000X MA060824 NJ Primary

Addresses

Primary practice location

1451 Route 88
Suite 5
Brick, NJ 08724-2371

Mailing address

PO Box 334
Allenhurst, NJ 07711-0334
Phone (732) 660-0202

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
I20060313000117 NJ Practitioner - Physical Medicine and Rehabilitation 5991712226 Practice locations: Allenhurst, NJ; Brick, NJ

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
New York University School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1451 Route 88 5
Brick, NJ 08724-2371
Phone (732) 660-0202

1451 Route 88 W
Suite 5
Brick, NJ 08724-2371

425 Jack Martin Blvd
Brick, NJ 08724-7732
Phone (732) 660-0202

Hospital & facility affiliations

  • Hackensack Meridian at Home Ocean County Home health agency, Brick, NJ, CCN 317075
  • Ocean Medical Center Hospital, Brick, NJ, CCN 310052
  • Jersey Shore University Medical Center Hospital, Neptune, NJ, CCN 310073
  • JFK University Medical Center Hospital, Edison, NJ, CCN 310108
  • Monmouth Medical Center Hospital, Long Branch, NJ, CCN 310075
  • Johnson Rehabilitation Institute at Omc Inpatient rehabilitation facility, Brick, NJ, CCN 31T052

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA060824NJMDRehabilitation Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Richard G. Fernicola, MD PastSince Jan 1, 1990 Accepting new patients

Organizations & group practices 1

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.

Hospital & facility affiliations 10

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": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266451200000",
    "number": "1487723615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 334",
            "city": "ALLENHURST",
            "state": "NJ",
            "postal_code": "077110334",
            "telephone_number": "732-660-0202",
            "fax_number": "732-660-0233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1451 ROUTE 88",
            "address_2": "SUITE 5",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087242371",
            "telephone_number": "732-660-0202",
            "fax_number": "732-660-0233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNICOLA",
        "first_name": "RICHARD",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-06",
        "last_updated": "2010-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "NJ",
            "license": "MA060824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brick, NJ

Sources for this page

Verify at the official NPI Registry.