Beacon of Life Central NJ

Primary specialty

PACE Provider OrganizationTaxonomy code 251T00000X

Legal business name

BEACON OF LIFE CENTRAL NJ

Practice address

800 Route 70
Lakehurst, NJ 08733-2734

Phone

(732) 716-4600

NPI assigned

Dec 7, 2021

Organization subpart

No

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

Authorized official

Name

Michael Czermak

Title

Chief Administrative Officer

Phone

(855) 801-2653

Specialties & licenses 1

Addresses

Other names 2

• BoldAge PACE Central NJ Doing business as
• BoldAge PACE Other name

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Acutecare Health System LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

• Acutecare Health System LLC

  • Long Term Care Hospital
  • Lakewood, NJ
  • NPI 1659376317
  NPD tax ID
• Acutecare Health System- Pharmacy Dept.

  • Pharmacist
  • Lakewood, NJ
  • NPI 1285887455
  NPD tax ID
• Beacon of Life Central NJ

  • PACE Provider Organization
  • Oceanport, NJ
  • NPI 1942678396
  NPD tax ID

Locations

Practitioners 2

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

• Kimberly Ann Hitchens, FNP-C

  • Nurse Practitioner
  • Lakehurst, NJ
  • NPI 1427690064
  NPD
• Christina J Wagener, APN

  • Nurse Practitioner
  • Crestwood, IL
  • NPI 1033469994
  NPD (past)

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

{
    "created_epoch": "1638835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744243200000",
    "number": "1700544798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 W MOORE AVE STE A",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281153552",
            "telephone_number": "732-806-3205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 ROUTE 70",
            "city": "LAKEHURST",
            "state": "NJ",
            "postal_code": "087332734",
            "telephone_number": "732-716-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACON OF LIFE CENTRAL NJ",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-07",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-10",
        "status": "A",
        "authorized_official_last_name": "CZERMAK",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CHIEF ADMINISTRATIVE OFFICER",
        "authorized_official_telephone_number": "855-801-2653"
    },
    "taxonomies": [
        {
            "code": "251T00000X",
            "taxonomy_group": "",
            "desc": "Program of All-Inclusive Care for the Elderly (PACE) Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BoldAge PACE Central NJ",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BoldAge PACE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Omar Amer, DPT, PT
• Mark Immanuel Auerbach, DPT
• Board of Education, Lakehurst
• Robert Jay Bodine, RPH
• Branch Medical Clinic Lakehurst
• Brian S Klohn DMD PA
• April Michelle Chillemi, LCSW

• PACE Provider Organization in Lakehurst, NJ
• Providers in Lakehurst, NJ by specialty
• PACE Provider Organization in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.