Michael J Raguso-Failla, MD
Individual provider Active NPI Family Medicine Physician · Little Egg Harbor, NJ
NPI 1497837744 · NPPES record last updated Aug 26, 2024
Key facts
- NPI
- 1497837744
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 25MA07211200 (NJ)
- Practice address
- 279 Mathistown Rd
Little Egg Harbor, NJ 08087 - Phone
- (609) 296-1101
- NPI assigned
- Oct 19, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- New York Medical College, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Hackensack Meridian Health Medical Group - Primary Care PC
Practice addresses (Care Compare)
1173 Beacon Ave
Suite B
Manahawkin, NJ 08050-2531
Phone (609) 597-7394
279 Mathistown Rd
Little Egg Harbor TWP, NJ 08087-4021
Phone (609) 296-1101
985 Cedar Bridge Ave
Brick, NJ 08723-4167
Phone (732) 477-5600
Hospital & facility affiliations
- Hackensack Meridian at Home Ocean County
- Bayada Home Health Care, Inc
- Southern Ocean Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101015001223 | NJ | Practitioner - Family Practice | 4183645120 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA07211200 | NJ | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Atlanticare Physician Group PA | Family Medicine | Current | Accepting new patients |
| Atlanticare Physician Group, PA | Current |
Accepting new patients | |
| Atlanticare Physician Group | Current |
Accepting new patients | |
| Hackensack Meridian Health Medical Group - Primary Care PC | Family Medicine | Current |
Accepting new patients |
Locations
985 Cedar Bridge Ave
Brick, NJ 08723
Phone (732) 477-5600
279 Mathistown Rd
Little Egg Harbor Twp, NJ 08087
Phone (609) 296-1101
459 Route 9 S
Little Egg Harbor Twp, NJ 08087
Phone (609) 340-7815
1173 Beacon Ave
Ste B
Manahawkin, NJ 08050
Phone (609) 597-1991
331 Newman Springs Rd
Ste 220
Red Bank, NJ 07701
Phone (732) 807-0514
Interoperability endpoints
- https://mepic.hmhn.org/fhir/api/FHIR/R4/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 25MA07211200 | NJ | Yes |
Addresses
Primary practice location
279 Mathistown Rd
Little Egg Harbor, NJ 08087
Mailing address
331 Newman Springs Rd
BLDG 2, Ste 220
Red Bank, NJ 07701-5688
Other practice location 1
1301 Route 72 W
Suite 240
Manahawkin, NJ 08050-2417
Phone (609) 597-7394
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001354216 | Medicaid | NJ | |
| 223106655 | Other | TAX ID |
Other providers in Little Egg Harbor, NJ
- Mystic Pharmacy Inc
- O'Rourke Family Chiropractic , LLC
- Joseph P O'Rourke
- Ocean Health Initiatives Inc
- Ocean Health Initiatives,Inc
- Rehabclinics SPT Inc.
- Seaport Chiropractic Center
- Lisa Stewart
- Raymond Stover
- Toby W Tracy
All providers in Little Egg Harbor, NJ · Family Medicine Physician in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 26, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.