Individual provider Active NPI

Emmanuel Amofah, DO

  • Family Medicine Physician
  • Mullica Hill, NJ
National Provider Identifier
1639708498
Registry record updated Jun 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MB11751600 Issued in NJ
Practice address
155 Bridgeton Pike
Mullica Hill, NJ 08062-2638
Phone
(856) 223-0500
NPI assigned
Apr 3, 2020
Last updated
Jun 9, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25MB11751600 NJ Primary

Addresses

Primary practice location

155 Bridgeton Pike
Mullica Hill, NJ 08062-2638

Mailing address

165 Bridgeton Pike
Mullica Hill, NJ 08062-2669

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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 1

Enrollment IDStateProvider typePAC IDDetails
I20230425003024 NJ Practitioner - Family Practice 6608231766 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Rowan University School of Osteopathic Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inspira Health Network Medical Group PCGroup PAC ID 4880797570, 238 clinicians

Practice addresses (Care Compare)

155 Bridgeton Pike
Suite a
Mullica Hill, NJ 08062-2639
Phone (856) 223-0500

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tricare at Inspira CurrentSince Aug 11, 2024 Accepting new patients
Inspira Health Network Medical Group, P.C. CurrentSince Mar 15, 2023 Accepting new patients

Locations

1120 Delsea Dr N
Glassboro, NJ 08028
Phone (856) 205-7071

200 Rowan Blvd
Glassboro, NJ 08028
Phone (856) 582-0500

155 Bridgeton Pike
Mullica Hill, NJ 08062
Phone (856) 223-0500

155 Bridgeton Pike
Ste A
Mullica Hill, NJ 08062
Phone (856) 223-0500

165 Bridgeton Pike
Mullica Hill, NJ 08062
Phone (800) 467-7472

798 Centerton Rd
Pittsgrove, NJ 08318
Phone (856) 358-6161

1505 W Sherman Ave
Vineland, NJ 08360
Phone (856) 451-6600

17 W Red Bank Ave
Ste 104
Woodbury, NJ 08096
Phone (856) 848-0665

Organizations & group practices 2

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 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": "1585872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686268800000",
    "number": "1639708498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 BRIDGETON PIKE",
            "city": "MULLICA HILL",
            "state": "NJ",
            "postal_code": "080622669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 BRIDGETON PIKE",
            "city": "MULLICA HILL",
            "state": "NJ",
            "postal_code": "080622638",
            "telephone_number": "856-223-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMOFAH",
        "first_name": "EMMANUEL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-03",
        "last_updated": "2023-06-09",
        "certification_date": "2023-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MB11751600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mullica Hill, NJ

Sources for this page

Verify at the official NPI Registry.