NPIMap

Organization Active NPI

West Jersey Anesthesia Associate PA

  • Anesthesiology Physician
  • Marlton, NJ
National Provider Identifier
1609861947
Registry record updated Mar 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
WEST JERSEY ANESTHESIA ASSOCIATE PA
Practice address
102 Centre Blvd
E
Marlton, NJ 08053-4129
Phone
(856) 988-6260
Fax
(856) 988-6270
NPI assigned
Sep 13, 2005
Last updated
Mar 26, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2014

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

Authorized official

Name
Todd G Hermann, MDNPI 1235138678
Title
President
Phone
(856) 988-6260

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X Primary

Addresses

Primary practice location

102 Centre Blvd
E
Marlton, NJ 08053-4129

Mailing address

102 Centre Blvd
E
Marlton, NJ 08053-4129
Phone (856) 988-6260

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040407000191 NJ Part B Supplier - Clinic/Group Practice 6507859386 Receives reassigned benefits from 124 practitioners
Practice locations: Sewell, NJ; Voorhees, NJ; Marlton, NJ

National Provider Directory

National Provider Directory

Locations

2401 E Evesham Rd
Ste A
Voorhees, NJ 08043
Phone (800) 355-0913

Practitioners & affiliated clinicians

Practitioners 131

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 131

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1126569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395792000000",
    "number": "1609861947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 CENTRE BLVD",
            "address_2": "E",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080534129",
            "telephone_number": "856-988-6260",
            "fax_number": "856-988-6270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 CENTRE BLVD",
            "address_2": "E",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080534129",
            "telephone_number": "856-988-6260",
            "fax_number": "856-988-6270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST JERSEY ANESTHESIA ASSOCIATE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-13",
        "last_updated": "2014-03-26",
        "status": "A",
        "authorized_official_last_name": "HERMANN",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "856-988-6260",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marlton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.