NPIMap

Organization Active NPI

State of New Jersey Omb Centralized Payroll

  • Psychiatric Hospital
  • Hammonton, NJ
National Provider Identifier
1629155502
Registry record updated Jul 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric HospitalTaxonomy code 283Q00000X
Legal business name
STATE OF NEW JERSEY OMB CENTRALIZED PAYROLL
Practice address
301 Spring Garden Rd
Hammonton, NJ 08037-2516
Phone
(609) 561-1700
Fax
(609) 561-1858
NPI assigned
Oct 31, 2006
Last updated
Jul 1, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2014

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

Authorized official

Name
Dr. David Roat, MD
Title
Medical Director
Phone
(609) 567-7300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital 283Q00000X Primary

Addresses

Primary practice location

301 Spring Garden Rd
Hammonton, NJ 08037-2516

Mailing address

301 Spring Garden Rd
Hammonton, NJ 08037-9699
Phone (609) 561-1700

Other names 1

  • Ancora Psychiatric Hospital Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040225000797 NJ Part B Supplier - Clinic/Group Practice 6406742592 Receives reassigned benefits from 61 practitioners
Practice locations: Hammonton, NJ
O20101221001029 NJ Part A Provider - Hospital 6406742592 Practice locations: Ancora, NJ

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1629155502. Details of each certification follow.

Hospital certification: CCN 314005

Legal name
STATE OF NEW JERSEY OMB CENTRALIZED PAYROLL
Doing business as
ANCORA PYSCHIATRIC HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Psychiatric
Participating since
Jul 1, 1966
Last certification
Sep 26, 2025
Beds
709
Ownership / control type
Other
Organization structure
GovernmentNon-profit
Enrollment address
301 Spring Garden Rd
Ancora Psychiatric Hospital
Ancora, NJ 80379699
Other Hospital Practice Location
Hospital subgroups
Psychiatric

Other NPIs with the same Medicare PAC ID 8

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospital

Medicare Care Compare
Listed as
Ancora Psych HospCCN 314005 · All quality measures
Type
Psychiatric
Ownership
Voluntary non-profit - Other
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

National Provider Directory

National Provider Directory
Tax ID family
Hunterdon Development C22 organizations share this tax ID, including this one

Other organizations with this tax ID 21

Organizations that report the same tax identification number in the National Provider Directory.

View all 21

Ownership & related parties

All disclosed owners & managing parties 6

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Joy Korngut Individual W-2 Managing EmployeeProgram Specialist 1 Aug 5, 2018
Kimberly Gardiner Individual W-2 Managing EmployeeMedical Records Technician Nov 29, 2018
Satya N Vatti Individual Operational/Managerial ControlProgram Manager Health Human Ser Oct 1, 2017
Cynthia R Vetrano Individual W-2 Managing EmployeeAssociate Hospital Administrator Mar 5, 2005
Allen Masry Individual Corporate DirectorMedical Director Jul 1, 2013
Catherine Malone Individual W-2 Managing EmployeeMedical Records Supervisor May 5, 2003

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
New Jersey Veterans Memorial Home at ParamusParamus, NJ, CCN 315346 Skilled nursing facility Operational/Managerial Control
Other		 Jul 1, 1995
Jul 1, 1995

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 63

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 63

NPI Registry JSON

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404172800000",
    "number": "1629155502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 SPRING GARDEN RD",
            "city": "HAMMONTON",
            "state": "NJ",
            "postal_code": "080379699",
            "telephone_number": "609-561-1700",
            "fax_number": "609-561-1858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 SPRING GARDEN RD",
            "city": "HAMMONTON",
            "state": "NJ",
            "postal_code": "080372516",
            "telephone_number": "609-561-1700",
            "fax_number": "609-561-1858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF NEW JERSEY OMB CENTRALIZED PAYROLL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-31",
        "last_updated": "2014-07-01",
        "status": "A",
        "authorized_official_last_name": "ROAT",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "609-567-7300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ancora Psychiatric Hospital",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Hammonton, NJ

Sources for this page

Verify at the official NPI Registry.