NPIMap

Individual provider Active NPI

Jill Mortensen, D.O.

  • Geriatric Medicine (Family Medicine) Physician
  • Millville, NJ
National Provider Identifier
1609816511
Registry record updated Aug 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
MB46459 Issued in NJ
Practice address
1203 N High St
Suite a
Millville, NJ 08332-2530
Phone
(856) 327-0182
Fax
(856) 327-7381
NPI assigned
Jun 8, 2006
Last updated
Aug 6, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X MB46459 NJ Primary

Addresses

Primary practice location

1203 N High St
Suite a
Millville, NJ 08332-2530

Mailing address

1203 N High St
Suite a
Millville, NJ 08332-2530
Phone (856) 327-0182

Other identifiers 1

IdentifierTypeStateIssuer
3853900MedicaidNJ

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
I20051221000253 NJ Practitioner - Family PracticePractitioner - Geriatric Medicine 4789606575 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Geriatric Medicine
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cumberland Family Medicine LLCGroup PAC ID 7810919602, 4 clinicians

Practice addresses (Care Compare)

1203 N High St
Suite a
Millville, NJ 08332-2530
Phone (856) 327-0182

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MB46459NJMDGeriatric Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cumberland Family Medicine LLC Geriatric Medicine CurrentSince Jan 1, 2006 Accepting new patients
GPS Physician Group of New Jersey, PC CurrentSince Feb 28, 2019 Accepting new patients
Inspira Medical Centers, Inc. Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
The Cooper Health System Past Accepting new patients

Locations

1361 Route 72 W
Manahawkin, NJ 08050
Phone (609) 978-0600

1203 High St N
#A
Millville, NJ 08332
Phone (856) 327-0182

249 High St
Newton, NJ 07860
Phone (973) 383-5600

843 Wilbur Ave
Phillipsburg, NJ 08865
Phone (908) 454-2627

10 Sterling Dr
Piscataway, NJ 08854
Phone (732) 917-2900

1351 Old Freehold Rd
Toms River, NJ 08753
Phone (732) 240-0090

Interoperability endpoints

  • Direct secure messaging: jmortensen@cumberlandfamily.medentdirect.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407283200000",
    "number": "1609816511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1203 N HIGH ST",
            "address_2": "SUITE A",
            "city": "MILLVILLE",
            "state": "NJ",
            "postal_code": "083322530",
            "telephone_number": "856-327-0182",
            "fax_number": "856-327-7381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1203 N HIGH ST",
            "address_2": "SUITE A",
            "city": "MILLVILLE",
            "state": "NJ",
            "postal_code": "083322530",
            "telephone_number": "856-327-0182",
            "fax_number": "856-327-7381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORTENSEN",
        "first_name": "JILL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-08",
        "last_updated": "2014-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "NJ",
            "license": "MB46459",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3853900",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Millville, NJ

Sources for this page

Verify at the official NPI Registry.