NPIMap

Organization Active NPI

Atlantic Hospice, Inc.

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Pleasantville, NJ
National Provider Identifier
1851964449
Registry record updated Jul 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X
Legal business name
ATLANTIC HOSPICE, INC.
Practice address
8025 Black Horse Pike Ste 501
Pleasantville, NJ 08232-2967
Phone
(609) 822-7979
Fax
(609) 822-7980
NPI assigned
Jul 21, 2021
Organization subpart
Yes
Parent organization
ATLANTIC HOSPICE, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 21, 2021

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

Authorized official

Name
Dan Mikus
Title
Ceo
Phone
(609) 822-7979

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Internal Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RH0002X Primary

Addresses

Primary practice location

8025 Black Horse Pike Ste 501
Pleasantville, NJ 08232-2967

Mailing address

8025 Black Horse Pike Ste 501
Pleasantville, NJ 08232-2967
Phone (609) 822-7979

Other names 1

  • Angelic Palliative Care Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210809001351 NJ Part B Supplier - Clinic/Group Practice 9032334685 Receives reassigned benefits from 4 practitioners
Practice locations: Pleasantville, NJ

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Atlantic Hospice Inc2 organizations share this tax ID, including this one
Part of
Atlantic Hospice Inc

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

8025 Black Horse Pike
Ste 501B
Pleasantville, NJ 08232

1050 Mantua Pike
Fl 1
Wenonah, NJ 08090
Phone (856) 210-7679

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 6

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": "1626825600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626825600000",
    "number": "1851964449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8025 BLACK HORSE PIKE STE 501",
            "city": "PLEASANTVILLE",
            "state": "NJ",
            "postal_code": "082322967",
            "telephone_number": "609-822-7979",
            "fax_number": "609-822-7980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8025 BLACK HORSE PIKE STE 501",
            "city": "PLEASANTVILLE",
            "state": "NJ",
            "postal_code": "082322967",
            "telephone_number": "609-822-7979",
            "fax_number": "609-822-7980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTIC HOSPICE, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ATLANTIC HOSPICE, INC",
        "enumeration_date": "2021-07-21",
        "last_updated": "2021-07-21",
        "certification_date": "2021-07-21",
        "status": "A",
        "authorized_official_last_name": "MIKUS",
        "authorized_official_first_name": "DAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "609-822-7979"
    },
    "taxonomies": [
        {
            "code": "207RH0002X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Angelic Palliative Care",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Pleasantville, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2021; 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.