Individual provider Active NPI

Jermaine Ricardo Deacon, MD

  • Emergency Medicine Physician
  • Newark, NJ
National Provider Identifier
1609364686
Registry record updated Jul 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
25MA11072800 Issued in NJ
Practice address
201 Lyons Ave
Newark, NJ 07112-2027
Phone
(973) 926-6671
NPI assigned
Apr 25, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 25MA11072800 NJ Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

201 Lyons Ave
Newark, NJ 07112-2027

Mailing address

201 Lyons Ave
Newark, NJ 07112-2027

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220528000093 FL Practitioner - Emergency Medicine 8729466081 Reassigns benefits to 1 organization
I20220927002016 NJ Practitioner - Emergency MedicinePractitioner - Hospice/Palliative Care 8729466081 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Emergency Physicians Kang and Associates MD LLCGroup PAC ID 0143113878, 318 clinicians

Practice addresses (Care Compare)

601 E Rollins St
Orlando, FL 32803-1248
Phone (407) 303-5600

Hospital & facility affiliations

  • Adventhealth Waterman Hospital, Tavares, FL, CCN 100057
  • Adventhealth Orlando Hospital, Orlando, FL, CCN 100007

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Merit-based Incentive Payment System (MIPS)

Final score
87.07 of 100Reported as group
Quality
76.5
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA11072800NJMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rwjbh Emergency Medicine Associates, LLC Emergency Medicine CurrentSince Jun 17, 2022 Accepting new patients
Florida Emergency Physicians Kang and Associates MD LLC Emergency Medicine CurrentSince Jun 1, 2022 Accepting new patients
Rwjbh Observation Associates LLC Emergency Medicine CurrentSince Jun 17, 2022 Accepting new patients

Locations

1909 E Highway 50
Clermont, FL 34711
Phone (352) 717-3800

601 E Rollins St
Orlando, FL 32803
Phone (407) 303-1996

1643 NW 136th Ave
Ste 100
Sunrise, FL 33323
Phone (865) 500-1325

1000 Waterman Way
Tavares, FL 32778
Phone (352) 253-3333

225 Williamson St
Elizabeth, NJ 07202
Phone (908) 994-5204

600 River Ave
Lakewood, NJ 08701
Phone (732) 363-1900

201 Lyons Ave
Newark, NJ 07112
Phone (732) 923-7455

379 Campus Dr
Fl 4
Somerset, NJ 08873
Phone (732) 507-6545

110 Rehill Ave
Somerville, NJ 08876
Phone (908) 429-5833

99 State Route 37 W
Toms River, NJ 08755
Phone (732) 240-8000

1 Hamilton Health Pl
Trenton, NJ 08690
Phone (609) 584-6763

Organizations & group practices 3

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 3

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": "1524614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627344000000",
    "number": "1609364686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 LYONS AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071122027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 LYONS AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071122027",
            "telephone_number": "973-926-6671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEACON",
        "first_name": "JERMAINE",
        "middle_name": "RICARDO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-25",
        "last_updated": "2021-07-27",
        "certification_date": "2021-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "25MA11072800",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.