Gerald Detata, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

25MA04005400 Issued in NJ

Practice address

120 S White Horse Pike
Hammonton, NJ 08037-1804

Phone

(609) 567-2573

Fax

(609) 561-8046

NPI assigned

Jan 27, 2006

Last updated

Apr 27, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Atlanticare Physician Group PA

  • Clinic/Center
  • Egg Harbor Township, NJ
  • NPI 1093829608

  Family Medicine

  Medicare reassignment NPD
• Atlanticare Urgent Care Physicians LLC

  • Urgent Care Clinic/Center
  • Sicklerville, NJ
  • NPI 1083991616
  Medicare reassignment NPD
• Cape Regional Urgent Care LLC

  dba Cape Regional Urgent Care

  • Urgent Care Clinic/Center
  • Cape May Court House, NJ
  • NPI 1538470679
  Medicare reassignment NPD
• Prohealth Urgent Care Medicine of New Jersey LLP

  • Emergency Care Clinic/Center
  • Edgewater, NJ
  • NPI 1477927754
  Medicare reassignment NPD
• Atlanticare Physician Group, PA

  dba AtlantiCare Urgent Care

  • Urgent Care Clinic/Center
  • Galloway, NJ
  • NPI 1003820622
  NPD
• Cape Regional Urgent Care LLC

  dba Cape Regional Urgent Care

  • Urgent Care Clinic/Center
  • Hammonton, NJ
  • NPI 1649071481
  NPD

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

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461715200000",
    "number": "1902877079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 BRIDLEWOOD CT",
            "city": "TABERNACLE",
            "state": "NJ",
            "postal_code": "080889600",
            "telephone_number": "609-792-1092",
            "fax_number": "609-388-4373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 S WHITE HORSE PIKE",
            "city": "HAMMONTON",
            "state": "NJ",
            "postal_code": "080371804",
            "telephone_number": "609-567-2573",
            "fax_number": "609-561-8046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETATA",
        "first_name": "GERALD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-27",
        "last_updated": "2016-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA04005400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dental Care of Hammonton II LLC
• Dental Care of Hammonton, LLC
• Dominick Dephilippis, PH.D.
• Maura Desmond, MSW LSW
• Jonathan Peter Destasio, PHARMD
• Thomas Devenny Jr.
• Devineni R Prasad MD PA
• Diabetes & Endocrinology Associates of South Jersey
• Diabetes & Endocrinology Associates of South Jersey PC
• Kathleen Diblin, MS, CCC-SLP

• Family Medicine Physician in Hammonton, NJ
• Providers in Hammonton, NJ by specialty
• Family Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.