Active NPI
Edward Anthony Fernandez
- Allergy & Immunology Physician
- Brick, NJ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Allergy & Immunology Physician
- License
- 25MA12110000
- Practice address
- 1673 Route 88
Brick, NJ 08724-3071 - Phone
- (732) 458-2000
- Fax
- (732) 458-4523
- NPI assigned
- Mar 20, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Allergy & Immunology Physician | 207K00000X | 25MA12110000 | NJ | Primary |
Addresses
Primary practice location
1673 Route 88
Brick, NJ 08724-3071
Mailing address
1673 Route 88
Brick, NJ 08724-3071
Phone (732) 458-2000
Other practice location 1
1540 Route 138 Ste 103
Wall, NJ 07719-3766
Phone (732) 681-8700
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Allergy/Immunology
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1673
Suite 88
Brick Township, NJ 08724-3071
Phone (732) 458-2000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA12110000 | NJ | MD | Allergy & Immunology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ocean Allergy Partners, LLC | Allergy & Immunology | Current | Accepting new patients |
| Bruce a. Decotiis MD PA | Allergy & Immunology | Past | Accepting new patients |
Locations
1540 State Route 138
Ste 103
Wall, NJ 07719
Phone (732) 280-2700
1673 Route 88 W
Wall Township, NJ 08724
Phone (732) 458-2000
Organizations & group practices 2
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.
-
- Allergy & Immunology Physician
- Brick, NJ
- NPI 1821753849
-
- Allergy & Immunology Physician
- Brick, NJ
- NPI 1861579559
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba HMH Behavioral Health Home
- Clinic/Center
- Neptune, NJ
- NPI 1053880286
Hospital
-
dba Ocean Medical Center
- General Acute Care Hospital
- Brick, NJ
- NPI 1477065126
-
dba Jersey Shore University Medical Center
- General Acute Care Hospital
- Neptune, NJ
- NPI 1790297547
-
dba Hackensack Meridian Diagnostic Laboratory
- Clinical Medical Laboratory
- Brick, NJ
- NPI 1942927538
Hospital
-
dba Hackensack Meridian Diagnostic Laboratory
- Clinical Medical Laboratory
- Neptune City, NJ
- NPI 1962128496
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1553040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724630400000",
"number": "1902366529",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1673 ROUTE 88",
"city": "BRICK",
"state": "NJ",
"postal_code": "087243071",
"telephone_number": "732-458-2000",
"fax_number": "732-458-4523"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1673 ROUTE 88",
"city": "BRICK",
"state": "NJ",
"postal_code": "087243071",
"telephone_number": "732-458-2000",
"fax_number": "732-458-4523"
}
],
"practiceLocations": [
{
"address_1": "1540 Route 138 Ste 103",
"address_purpose": "LOCATION",
"city": "Wall",
"state": "NJ",
"postal_code": "077193766",
"country_code": "US",
"telephone_number": "732-681-8700",
"fax_number": "732-749-3737",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FERNANDEZ",
"first_name": "EDWARD",
"middle_name": "ANTHONY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-03-20",
"last_updated": "2024-08-26",
"certification_date": "2024-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "207K00000X",
"taxonomy_group": "",
"desc": "Allergy & Immunology",
"state": "NJ",
"license": "25MA12110000",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Brick, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.