Michael Jerome Feeney, PA
Individual provider Active NPI Physician Assistant · JB MDL, NJ
NPI 1740263284 · NPPES record last updated Apr 22, 2022
Key facts
- NPI
- 1740263284
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 25MP00438800 (NJ)
- Practice address
- 3458 Neely Rd
JB MDL, NJ 08641-5312 - Phone
- (609) 754-9297
- Fax
- (609) 754-9223
- NPI assigned
- Nov 29, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MP00438800 | NJ | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| United Health Services Hospitals, Inc. | Past |
Accepting new patients | |
| Delaware Valley Hospital, Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 004964 | NY | |
| Physician Assistant | 363A00000X | 25MP00438800 | NJ | Yes |
Addresses
Primary practice location
3458 Neely Rd
JB MDL, NJ 08641-5312
Mailing address
3458 Neely Rd
JB MDL, NJ 08641-5312
Phone (609) 754-9692
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01531548 | Medicaid | NY |
Other providers in JB MDL, NJ
- Dennis M Boyer
- Samantha Caceres
- David C Dimoplon
- Stephen Dorse
- Rachel F Ennis
- Peter Fiasca
- Nicole Lynn Hawley
- Susan Jill Hicks
- Noana Issar-Grill
- Crystal Kellert
All providers in JB MDL, NJ · Physician Assistant in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 22, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.