Organization Active NPI

Michael S Rogers MD PA

  • Family Medicine Physician
  • West Deptford, NJ
National Provider Identifier
1710946447
Registry record updated Feb 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MICHAEL S ROGERS MD PA
Practice address
831 Kings Hwy
Suite 100
West Deptford, NJ 08096-3162
Phone
(856) 853-8730
Fax
(856) 853-8870
NPI assigned
Mar 21, 2006
Last updated
Feb 1, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2013

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

Authorized official

Name
Mrs. Elaine Larthey
Title
Om
Phone
(856) 853-8730

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

831 Kings Hwy
Suite 100
West Deptford, NJ 08096-3162

Mailing address

831 Kings Hwy
Suite 100
West Deptford, NJ 08096-3162
Phone (856) 853-8730

Other identifiers 5

IdentifierTypeStateIssuer
6444407MedicaidNJ
000786022001OtherNJUNITED HEALTHCARE
0762906002OtherNJAMERIHEALTH
000614452OtherNJIBC
10872OtherNJAETNA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100423000783 NJ Part B Supplier - Clinic/Group Practice 4688701543 Receives reassigned benefits from 6 practitioners
Practice locations: West Deptford, NJ

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
31D0875126Michael S Rogers MD PA831 Kings Highway Suite 100, West Deptford, NJ 08096Provider-performed microscopyAug 17, 2027

National Provider Directory

National Provider Directory

Locations

831 Kings Hwy
Ste 100
West Deptford, NJ 08096
Phone (856) 853-8730

Practitioners & affiliated clinicians

Practitioners 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1142899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359676800000",
    "number": "1710946447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "831 KINGS HWY",
            "address_2": "SUITE 100",
            "city": "WEST DEPTFORD",
            "state": "NJ",
            "postal_code": "080963162",
            "telephone_number": "856-853-8730",
            "fax_number": "856-853-8870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "831 KINGS HWY",
            "address_2": "SUITE 100",
            "city": "WEST DEPTFORD",
            "state": "NJ",
            "postal_code": "080963162",
            "telephone_number": "856-853-8730",
            "fax_number": "856-853-8870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL S ROGERS MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-21",
        "last_updated": "2013-02-01",
        "status": "A",
        "authorized_official_last_name": "LARTHEY",
        "authorized_official_first_name": "ELAINE",
        "authorized_official_title_or_position": "OM",
        "authorized_official_telephone_number": "856-853-8730",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6444407",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "000786022001",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "0762906002",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IBC",
            "identifier": "000614452",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "10872",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Deptford, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.