NPIMap

Organization Active NPI

New Age Behavioral PC

  • Psychiatric/Mental Health Nurse Practitioner
  • Marlton, NJ
National Provider Identifier
1689089344
Registry record updated Mar 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
26NJ00433300 Issued in NJ
Legal business name
NEW AGE BEHAVIORAL PC
Practice address
106 Centre Blvd
Suite G
Marlton, NJ 08053-4131
Phone
(856) 797-2810
Fax
(856) 797-2811
NPI assigned
Jun 20, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2015

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

Authorized official

Name
Dr. Lloyd C Alcera, M.D.NPI 1184854259
Title
Director
Phone
(856) 797-2810

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
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X 26NJ00433300 NJ Primary

Addresses

Primary practice location

106 Centre Blvd
Suite G
Marlton, NJ 08053-4131

Mailing address

106 Centre Blvd
Suite G
Marlton, NJ 08053-4131
Phone (856) 797-2810

Other names 1

  • New AGE Behavioral Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141015000176 NJ Part B Supplier - Clinic/Group Practice 4688895717 Receives reassigned benefits from 5 practitioners
Practice locations: Marlton, NJ

National Provider Directory

National Provider Directory

Locations

106 Centre Blvd
Ste G
Marlton, NJ 08053
Phone (856) 797-2810

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1403222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425254400000",
    "number": "1689089344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 CENTRE BLVD",
            "address_2": "SUITE G",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080534131",
            "telephone_number": "856-797-2810",
            "fax_number": "856-797-2811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 CENTRE BLVD",
            "address_2": "SUITE G",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080534131",
            "telephone_number": "856-797-2810",
            "fax_number": "856-797-2811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW AGE BEHAVIORAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-20",
        "last_updated": "2015-03-02",
        "status": "A",
        "authorized_official_last_name": "ALCERA",
        "authorized_official_first_name": "LLOYD",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "856-797-2810",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ00433300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New AGE Behavioral",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 2, 2015; 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.