Individual provider Active NPI

Alexander Fishman, D.O.

  • Emergency Medicine Physician
  • Livingston, NJ
National Provider Identifier
1518344019
Registry record updated Jun 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
25MB10613000 Issued in NJ
Practice address
39 Intervale Rd
Livingston, NJ 07039-2739
Phone
(973) 820-6496
NPI assigned
May 4, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 25MB10613000 NJ Primary

Addresses

Primary practice location

39 Intervale Rd
Livingston, NJ 07039-2739

Mailing address

39 Intervale Rd
Livingston, NJ 07039-2739
Phone (973) 820-6496

Other identifiers 1

IdentifierTypeStateIssuer
0696048MedicaidNJ

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190730004469 NJ Practitioner - Emergency Medicine 7012243900 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Care Services of New Jersey PAGroup PAC ID 2567534100, 14 clinicians

Practice addresses (Care Compare)

509 N Broad St
Woodbury, NJ 08096-1617
Phone (856) 853-2001

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Care Services of New Jersey, PA Emergency Medicine CurrentSince Jun 11, 2019 Accepting new patients
South Jersey Health System Emergency Physician Services P a Emergency Medicine CurrentSince Sep 1, 2019 Accepting new patients

Locations

1505 W Sherman Ave
Vineland, NJ 08360
Phone (856) 451-6600

509 N Broad St
Woodbury, NJ 08096
Phone (856) 686-5396

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1430697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686268800000",
    "number": "1518344019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 INTERVALE RD",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070392739",
            "telephone_number": "973-820-6496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 INTERVALE RD",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070392739",
            "telephone_number": "973-820-6496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHMAN",
        "first_name": "ALEXANDER",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-05-04",
        "last_updated": "2023-06-09",
        "certification_date": "2023-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "25MB10613000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0696048",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Livingston, NJ

Sources for this page

Verify at the official NPI Registry.