NPIMap

Organization Active NPI

Excelcare Alliance, LLC

  • Family Medicine Physician
  • Vineland, NJ
National Provider Identifier
1891090510
Registry record updated Aug 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
EXCELCARE ALLIANCE, LLC
Practice address
76 S State St
Vineland, NJ 08360-4851
Phone
(856) 205-1112
Fax
(856) 205-1114
NPI assigned
Jan 12, 2011
Last updated
Aug 6, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2024

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

Authorized official

Name
Raghuraj Tomar, MDNPI 1467412858
Title
President
Phone
(856) 205-1112

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NJ Primary
Internal Medicine Physician 207R00000X NJ
Cardiovascular Disease Physician 207RC0000X NU
Nephrology Physician 207RN0300X NU
Pulmonary Disease Physician 207RP1001X NU
Rheumatology Physician 207RR0500X NU
Pediatrics Physician 208000000X NJ

Addresses

Primary practice location

76 S State St
Vineland, NJ 08360-4851

Mailing address

76 S State St
Vineland, NJ 08360-4851
Phone (856) 205-1112

Other identifiers 1

IdentifierTypeStateIssuer
0261165MedicaidNJ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110830000049 NJ Part B Supplier - Clinic/Group Practice 0941470082 Receives reassigned benefits from 45 practitioners
Practice locations: Vineland, NJ; Mullica Hill, NJ; Bridgeton, NJ

National Provider Directory

National Provider Directory

Locations

215 Laurel Heights Dr
Bridgeton, NJ 08302
Phone (856) 455-6002

1138 E Chestnut Ave
Bldg A
Vineland, NJ 08360
Phone (856) 691-1230

1138 E Chestnut Ave
Ste 8A
Vineland, NJ 08360
Phone (856) 691-1230

1206 W Sherman Ave
Bldg 1
Vineland, NJ 08360
Phone (856) 462-6250

1206 W Sherman Ave
Bldg 2A
Vineland, NJ 08360
Phone (856) 696-9933

2815 E Chestnut Ave
Ste C
Vineland, NJ 08361

76 S State St
Vineland, NJ 08360
Phone (856) 205-1112

799 S Delsea Dr
Vineland, NJ 08360
Phone (856) 478-2111

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/12810/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 48

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 48

NPI Registry JSON

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

{
    "created_epoch": "1294790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722902400000",
    "number": "1891090510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 S STATE ST",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083604851",
            "telephone_number": "856-205-1112",
            "fax_number": "856-205-1114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76 S STATE ST",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083604851",
            "telephone_number": "856-205-1112",
            "fax_number": "856-205-1114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCELCARE ALLIANCE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-12",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A",
        "authorized_official_last_name": "TOMAR",
        "authorized_official_first_name": "RAGHURAJ",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "856-205-1112",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0261165",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vineland, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2024; 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.