Individual provider Active NPI

Ellen B Ganek, MD

  • Pediatrics Physician
  • Bernardsville, NJ
National Provider Identifier
1750379228
Registry record updated Mar 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
25MA07389600 Issued in NJ
Practice address
169 Mine Brook Rd
Bernardsville, NJ 07924-2109
Phone
(908) 766-0034
Fax
(908) 766-4387
NPI assigned
Oct 10, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 25MA07389600 NJ Primary

Addresses

Primary practice location

169 Mine Brook Rd
Bernardsville, NJ 07924-2109

Mailing address

402 Lippincott Dr
Marlton, NJ 08053-4112
Phone (856) 782-3300

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20201123000733 NJ Practitioner - Pediatric Medicine 3072924125 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA07389600NJMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advocare , LLC CurrentSince Nov 23, 2020 Accepting new patients
Advocare, LLC Pediatrics CurrentSince Nov 23, 2020 Accepting new patients
Advocare, LLC Pediatrics Past Accepting new patients

Locations

169 Mine Brook Rd
#P
Bernardsville, NJ 07924
Phone (908) 766-0034

169 Mine Brook Rd
Bernardsville, NJ 07924
Phone (908) 221-1132

195 Columbia Tpke
Ste 105
Florham Park, NJ 07932
Phone (973) 437-8300

132 Grove St
Ste A
Haddonfield, NJ 08033
Phone (856) 354-2211

402 Lippincott Dr
Marlton, NJ 08053
Phone (410) 763-8787

401 Route 73 N
Ste 320
Marlton, NJ 08053
Phone (609) 471-1033

Interoperability endpoints

  • Direct secure messaging: ellen.ganek@advocaredoctors.eclinicaldirectplus.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1128902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268784000000",
    "number": "1750379228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 LIPPINCOTT DR",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080534112",
            "telephone_number": "856-782-3300",
            "fax_number": "856-504-8029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 MINE BROOK RD",
            "city": "BERNARDSVILLE",
            "state": "NJ",
            "postal_code": "079242109",
            "telephone_number": "908-766-0034",
            "fax_number": "908-766-4387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANEK",
        "first_name": "ELLEN",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-10",
        "last_updated": "2010-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA07389600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bernardsville, NJ

Sources for this page

Verify at the official NPI Registry.