Active NPI
Ambulatory Care Center PA
- Ambulatory Surgical Clinic/Center
- Vineland, NJ
National Provider Identifier
1528024114
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Surgical Clinic/Center
- Legal business name
- AMBULATORY CARE CENTER PA
- Practice address
- 1133 East Chestnut Ave.
Vineland, NJ 08360 - Phone
- (856) 507-0800
- Fax
- (856) 507-0824
- NPI assigned
- Apr 24, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Melissa Ritter Hermanson
- Title
- Administrator
- Phone
- (856) 507-0800
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Surgical Clinic/Center | 261QA1903X | 22422 | NJ | |
| Ambulatory Surgical Clinic/Center | 261QA1903X | NJ | Primary |
Addresses
Primary practice location
1133 East Chestnut Ave.
Vineland, NJ 08360
Mailing address
1133 East Chestnut Ave.
Vineland, NJ 08360
Phone (856) 507-0800
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7594305 | Medicaid | NJ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100308000550 | NJ | Part B Supplier - Ambulatory Surgical Center | 2264577881 | Practice locations: Vineland, NJ |
Care Compare: Ambulatory surgical center
Medicare Care Compare- Listed as
- Ambulatory Care Center
- Medicare certification status
- Active
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 31D1051980 | Ambulatory Care Center | Certificate of waiver | Mar 14, 2028 |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Orthopaedic Surgery Physician
- Vineland, NJ
- NPI 1750381521
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145836800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1687392000000",
"number": "1528024114",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1133 EAST CHESTNUT AVE.",
"city": "VINELAND",
"state": "NJ",
"postal_code": "08360",
"telephone_number": "856-507-0800",
"fax_number": "856-507-0824"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1133 EAST CHESTNUT AVE.",
"city": "VINELAND",
"state": "NJ",
"postal_code": "08360",
"telephone_number": "856-507-0800",
"fax_number": "856-507-0824"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "AMBULATORY CARE CENTER PA",
"organizational_subpart": "NO",
"enumeration_date": "2006-04-24",
"last_updated": "2023-06-22",
"certification_date": "2023-06-22",
"status": "A",
"authorized_official_last_name": "HERMANSON",
"authorized_official_first_name": "MELISSA",
"authorized_official_middle_name": "RITTER",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "856-507-0800"
},
"taxonomies": [
{
"code": "261QA1903X",
"taxonomy_group": "",
"desc": "Clinic/Center, Ambulatory Surgical",
"state": "NJ",
"license": "22422",
"primary": false
},
{
"code": "261QA1903X",
"taxonomy_group": "",
"desc": "Clinic/Center, Ambulatory Surgical",
"state": "NJ",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7594305",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Vineland, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.