NPIMap

Individual provider Active NPI

Michael Devita, D.O.

  • Cardiovascular Disease Physician
  • Brick, NJ
National Provider Identifier
1790766277
Registry record updated Feb 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
25MB06428600 Issued in NJ
Practice address
1640 Highway 88
Suite 201
Brick, NJ 08724-3036
Phone
(732) 840-1900
Fax
(732) 840-0355
NPI assigned
Nov 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 25MB06428600 NJ Primary

Addresses

Primary practice location

1640 Highway 88
Suite 201
Brick, NJ 08724-3036

Mailing address

1640 Highway 88
Suite 201
Brick, NJ 08724-3036
Phone (732) 840-1900

Other identifiers 1

IdentifierTypeStateIssuer
0001511MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040922000163 NJ Practitioner - Cardiovascular Disease (Cardiology) 3779551304 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
New York College of Osteo Medicine of New York Institute of Technology, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shore Cardiology Consultants LLCGroup PAC ID 0547239717, 4 clinicians
Meridian Cardiovascular Interpretive Services PCGroup PAC ID 8527012236, 60 clinicians

Practice addresses (Care Compare)

1640 Hwy 88
Suite 201
Brick, NJ 08724-3068
Phone 7328401900300

1945 Route 33
Neptune, NJ 07753-4859
Phone (732) 776-4300

Hospital & facility affiliations

  • Ocean Medical Center Hospital, Brick, NJ, CCN 310052
  • Jersey Shore University Medical Center Hospital, Neptune, NJ, CCN 310073
  • JFK University Medical Center Hospital, Edison, NJ, CCN 310108
  • Community Medical Center Hospital, Toms River, NJ, CCN 310041
  • Southern Ocean Medical Center Hospital, Manahawkin, NJ, CCN 310113

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Meridian Cardiovascular Interpretive Services PC Cardiovascular Disease CurrentSince Dec 29, 2018 Accepting new patients
Shore Health Group, PC Cardiovascular Disease Past Accepting new patients

Locations

1945 State Route 33
Wall Township, NJ 07753
Phone (732) 776-2333

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.

Hospital & facility affiliations 9

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

NPI Registry JSON

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

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204243200000",
    "number": "1790766277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1640 HIGHWAY 88",
            "address_2": "SUITE 201",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087243036",
            "telephone_number": "732-840-1900",
            "fax_number": "732-840-0355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 HIGHWAY 88",
            "address_2": "SUITE 201",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087243036",
            "telephone_number": "732-840-1900",
            "fax_number": "732-840-0355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVITA",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-10",
        "last_updated": "2008-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NJ",
            "license": "25MB06428600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0001511",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brick, NJ

Sources for this page

Verify at the official NPI Registry.