Organization Active NPI

Atlantic ENT Associates, P.a.

  • Facial Plastic Surgery Physician
  • Manasquan, NJ
National Provider Identifier
1790998805
Registry record updated Jan 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Facial Plastic Surgery PhysicianTaxonomy code 207YS0123X
License
MB55529 Issued in NJ
Legal business name
ATLANTIC ENT ASSOCIATES, P.A.
Practice address
2640 Highway 70
Building 6B
Manasquan, NJ 08736-2609
Phone
(732) 223-8686
Fax
(732) 223-6572
NPI assigned
May 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2011

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

Authorized official

Name
Mrs. Roxanne D Hoffmann
Title
Office Manager
Phone
(732) 223-8686

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Facial Plastic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207YS0123X MB55529 NJ Primary

Addresses

Primary practice location

2640 Highway 70
Building 6B
Manasquan, NJ 08736-2609

Mailing address

2640 Highway 70
Building 6B
Manasquan, NJ 08736-2609
Phone (732) 223-8686

Other identifiers 1

IdentifierTypeStateIssuer
6217401MedicaidNJ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050208000732 NJ Part B Supplier - Clinic/Group Practice 8123079084 Receives reassigned benefits from 2 practitioners
Practice locations: Toms River, NJ

National Provider Directory

National Provider Directory

Locations

530 Lakehurst Rd
Ste 207
Toms River, NJ 08755
Phone (732) 557-4480

530 Lakehurst Rd
Ste 201
Toms River, NJ 08755
Phone (732) 557-4480

1 Plaza Dr
Unit 10
Toms River, NJ 08757
Phone (732) 557-4480

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295395200000",
    "number": "1790998805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2640 HIGHWAY 70",
            "address_2": "BUILDING 6B",
            "city": "MANASQUAN",
            "state": "NJ",
            "postal_code": "087362609",
            "telephone_number": "732-223-8686",
            "fax_number": "732-223-6572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2640 HIGHWAY 70",
            "address_2": "BUILDING 6B",
            "city": "MANASQUAN",
            "state": "NJ",
            "postal_code": "087362609",
            "telephone_number": "732-223-8686",
            "fax_number": "732-223-6572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTIC ENT ASSOCIATES, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-07",
        "last_updated": "2011-01-19",
        "status": "A",
        "authorized_official_last_name": "HOFFMANN",
        "authorized_official_first_name": "ROXANNE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "732-223-8686",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207YS0123X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "NJ",
            "license": "MB55529",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6217401",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manasquan, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.