Edward R. Fog, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

MB71314 Issued in NJ

Practice address

1925 Pacific Ave
Atlantic City, NJ 08401-6713

Phone

(609) 441-8127

NPI assigned

Jul 6, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

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

Specialty

Emergency Medicine

Education

Rowan University School of Osteopathic Medicine, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Atlanticare Physician Group PAGroup PAC ID 8527953660, 506 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Atlanticare Regional Medical Center - City Campus Hospital, Atlantic City, NJ, CCN 310064

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Atlanticare Physician Group PA

  • Clinic/Center
  • Egg Harbor Township, NJ
  • NPI 1093829608
  Medicare reassignment Care Compare group NPD
• Atlanticare Urgent Care Physicians LLC

  • Urgent Care Clinic/Center
  • Sicklerville, NJ
  • NPI 1083991616
  Medicare reassignment NPD
• Atlanticare Physician Group, PA

  • Urgent Care Clinic/Center
  • Galloway, NJ
  • NPI 1003820622
  NPD
• Emergency Physician Associates of South Jersey P C

  • Emergency Medicine Physician
  • Voorhees, NJ
  • NPI 1215965231
  NPD (past)
• Leeds Emergency Physicians

  • Emergency Medicine Physician
  • Atlantic City, NJ
  • NPI 1326248667
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Atlanticare Regional Medical Center

  • General Acute Care Hospital
  • Pomona, NJ
  • NPI 1013919315
  Care Compare affiliation

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198195200000",
    "number": "1699707232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 S EVERGREEN AVE",
            "city": "WOODBURY",
            "state": "NJ",
            "postal_code": "080962739",
            "telephone_number": "856-686-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1925 PACIFIC AVE",
            "city": "ATLANTIC CITY",
            "state": "NJ",
            "postal_code": "084016713",
            "telephone_number": "609-441-8127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOG",
        "first_name": "EDWARD",
        "middle_name": "R.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2007-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "MB71314",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "2090379000",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8837708",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON NJ HEALTH",
            "identifier": "60018857",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE MERCY",
            "identifier": "30028085",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sandra Festa, LCSW
• Sam Warren Finkelstein, DO
• Liza C Flancia, APN, FNP-C
• Alexandra Paige Fleck, DO
• FMS Atlantic City Holdings, LLC
• Amanda Forster
• Roseanne McDevitt Foxx, APN
• James M Foy, MPT
• Sophia A Francisco, DO
• Shannon Frecon, MSW

• Emergency Medicine Physician in Atlantic City, NJ
• Providers in Atlantic City, NJ by specialty
• Emergency Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.