NPIMap

Organization Active NPI

Ocean Health Initiatives, Inc.

  • Federally Qualified Health Center (FQHC)
  • Brick, NJ
National Provider Identifier
1679096796
Registry record updated Sep 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
OCEAN HEALTH INITIATIVES, INC.
Practice address
1610 Route 88
Brick, NJ 08724-3018
Phone
(732) 363-6655
NPI assigned
Jul 20, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2023

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

Authorized official

Name
Theresa Berger, MD
Title
Ceo
Phone
(732) 363-6655

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

1610 Route 88
Brick, NJ 08724-3018

Mailing address

3600 Route 66 Ste 400
Neptune, NJ 07753-2605
Phone (732) 363-6655

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040405001022 NJ Part B Supplier - Clinic/Group Practice 2062405277 Receives reassigned benefits from 136 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Toms River, NJ; Little Egg Harbor, NJ; Lakewood, NJ; Freehold, NJ; Clifton, NJ; Brick, NJ
O20171207001554 NJ Part A Provider - Federally Qualified Health Center (FQHC) 2062405277 Practice locations: Brick, NJ

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1679096796. Details of each certification follow.

Federally qualified health center certification: CCN 311938

Legal name
OCEAN HEALTH INITIATIVES, INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 31, 2017
Last certification
Dec 31, 2017
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
1610 Route 88
Ste 3 BLDG #3
Brick, NJ 87243018

Other NPIs with the same Medicare PAC ID 9

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

Other NPIs on the same Medicare enrollment 6

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

National Provider Directory

National Provider Directory
Tax ID family
Ocean Health Initatives Inc10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Ownership & related parties

All disclosed owners & managing parties 1

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

NameRoleSinceShare
Theresa Berger Individual Corporate OfficerBoard Chair Jul 15, 2017
Corporate DirectorCeo Jul 15, 2016 100%
W-2 Managing Employee Jul 15, 2016 100%

Practitioners & affiliated clinicians

Practitioners 17

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 17

NPI Registry JSON

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

{
    "created_epoch": "1500508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694649600000",
    "number": "1679096796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 ROUTE 66 STE 400",
            "city": "NEPTUNE",
            "state": "NJ",
            "postal_code": "077532605",
            "telephone_number": "732-363-6655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1610 ROUTE 88",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087243018",
            "telephone_number": "732-363-6655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OCEAN HEALTH INITIATIVES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-20",
        "last_updated": "2023-09-14",
        "certification_date": "2023-09-14",
        "status": "A",
        "authorized_official_last_name": "BERGER",
        "authorized_official_first_name": "THERESA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "732-363-6655",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brick, NJ

Sources for this page

Verify at the official NPI Registry.