NPIMap

Organization Active NPI

Children's Health Care Associates of New Jersey PC

  • Pediatrics Physician
  • Voorhees, NJ
National Provider Identifier
1669567681
Registry record updated Aug 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
CHILDREN'S HEALTH CARE ASSOCIATES OF NEW JERSEY PC
Practice address
1012 Laurel Oak Rd
Specialty Center at Voorhees - Chop
Voorhees, NJ 08043-3505
Phone
(856) 435-1300
Fax
(215) 977-8864
NPI assigned
Oct 4, 2006
Last updated
Aug 4, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2011

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

Authorized official

Name
Michael Corbo
Title
Finance Officer
Phone
(215) 567-2422

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X NU Primary

Addresses

Primary practice location

1012 Laurel Oak Rd
Specialty Center at Voorhees - Chop
Voorhees, NJ 08043-3505

Mailing address

100 N 20TH St Ste 301
Chca
Philadelphia, PA 19103-1454
Phone (215) 567-2422

Other identifiers 4

IdentifierTypeStateIssuer
02278884MedicaidNY
0001025402MedicaidDE
8241601MedicaidNJ
0006558520006MedicaidPA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031229000053 NJ Part B Supplier - Clinic/Group Practice 1052219110 Receives reassigned benefits from 193 practitioners
20 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Voorhees, NJ; Woodbury, NJ; Vineland, NJ; Somers Point, NJ; Princeton, NJ; Pomona, NJ; New Brunswick, NJ; Mount Holly, NJ…

Other NPIs on the same Medicare enrollment 20

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 20

National Provider Directory

National Provider Directory
Tax ID family
Children's Healthcare Associates of New Jersey PC28 organizations share this tax ID, including this one

Other organizations with this tax ID 27

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

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312416000000",
    "number": "1669567681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N 20TH ST STE 301",
            "address_2": "CHCA",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191031454",
            "telephone_number": "215-567-2422",
            "fax_number": "215-561-0959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1012 LAUREL OAK RD",
            "address_2": "SPECIALTY CENTER AT VOORHEES - CHOP",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080433505",
            "telephone_number": "856-435-1300",
            "fax_number": "215-977-8864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S HEALTH CARE ASSOCIATES OF NEW JERSEY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2011-08-04",
        "status": "A",
        "authorized_official_last_name": "CORBO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "FINANCE OFFICER",
        "authorized_official_telephone_number": "215-567-2422"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02278884",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0001025402",
            "state": "DE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8241601",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0006558520006",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Voorhees, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2011; 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.