Active NPI
Jay V Malickel, D.O.
- Family Medicine Physician
- Elmer, NJ
National Provider Identifier
1902893134
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MB06869400
- Practice address
- 798 Centerton Rd
Elmer, NJ 08318-3945 - Phone
- (856) 358-6161
- Fax
- (856) 358-0142
- NPI assigned
- Oct 3, 2005
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MB06869400 | NJ | Primary |
Addresses
Primary practice location
798 Centerton Rd
Elmer, NJ 08318-3945
Mailing address
PO Box 2284
Vineland, NJ 08362-2284
Phone (856) 358-6161
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 085366400 | Other | AMERIHEALTH | |
| 2325972 | Other | AETNA/HMO | |
| 60009045 | Other | NJ HEALTH | |
| 7591121 | Other | AETNA PIN | |
| 223772973 | Other | TAX ID | |
| 8223904 | Medicaid | NJ |
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
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040903000085 | NJ | Practitioner - Family Practice | 0648246405 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Rowan University School of Osteopathic Medicine, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Inspira Health Network Medical Group PC
Practice addresses (Care Compare)
70 Cornwell Dr
Bridgeton, NJ 08302-3602
Phone (856) 455-6770
Hospital & facility affiliations
- Bayada at Inspira, Home Health and Hospice
- Bayada at Inspira, Home Health and Hospice
- Inspira Medical Center Mullica Hill
- Inspira Medical Center Vineland
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MB06869400 | NJ | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Inspira Health Network Medical Group, P.C. | Current | Accepting new patients | |
| Cumberland Family Medicine LLC | Family Medicine | Past | Accepting new patients |
| Peripheral Vascular Institute of Philadelphia LLC | Past | Accepting new patients | |
| Inspira Medical Centers, Inc. | Past | Accepting new patients |
Locations
70 Cornwell Dr
Bridgeton, NJ 08302
Phone (856) 455-6770
798 Centerton Rd
Pittsgrove, NJ 08318
Phone (856) 358-6161
2848 S Delsea Dr
Ste 4B
Vineland, NJ 08360
Phone (856) 205-7070
1505 W Sherman Ave
Vineland, NJ 08360
Phone (856) 451-6600
17 W Red Bank Ave
Ste 104
Woodbury, NJ 08096
Phone (856) 848-0665
Interoperability endpoints
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
Organizations & group practices 4
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.
-
- Multi-Specialty Clinic/Center
- Glassboro, NJ
- NPI 1922177856
NJ
-
- Family Medicine Physician
- Millville, NJ
- NPI 1174689004
Family Medicine
-
- General Acute Care Hospital
- Vineland, NJ
- NPI 1164487542
-
- Vascular-Interventional Technology Radiologic Technologist
- Philadelphia, PA
- NPI 1396074480
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Community Based Hospice Care Agency
- West Deptford, NJ
- NPI 1427419001
Hospice
-
- Home Health Agency
- West Deptford, NJ
- NPI 1629431481
-
- Home Health Agency
- Millville, NJ
- NPI 1710340575
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128297600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1347235200000",
"number": "1902893134",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2284",
"city": "VINELAND",
"state": "NJ",
"postal_code": "083622284",
"telephone_number": "856-358-6161"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "798 CENTERTON RD",
"city": "ELMER",
"state": "NJ",
"postal_code": "083183945",
"telephone_number": "856-358-6161",
"fax_number": "856-358-0142"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALICKEL",
"first_name": "JAY",
"middle_name": "V",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-03",
"last_updated": "2012-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NJ",
"license": "MB06869400",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIHEALTH",
"identifier": "085366400",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA/HMO",
"identifier": "2325972",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NJ HEALTH",
"identifier": "60009045",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA PIN",
"identifier": "7591121",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID",
"identifier": "223772973",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8223904",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Elmer, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2012; 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.