Philip S Dennis, M.D.

Individual provider Active NPI Family Medicine Physician · Farmingdale, NJ

NPI 1942391313 · NPPES record last updated Mar 19, 2010

Key facts

NPI
1942391313
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
25MA08141800 (NJ)
Practice address
17 Casino Dr
Farmingdale, NJ 07727-3701
Phone
(270) 206-0069
Fax
(732) 256-4281
NPI assigned
Sep 28, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 1

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Medicare Care Compare profile

Specialty
Family Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

901 W Main St
Freehold, NJ 07728-2537
Phone (270) 206-0069

Hospital & facility affiliations

  • Centrastate Medical Center Hospital · Freehold, NJ · CCN 310111
  • Manor, the Nursing home · Freehold, NJ · CCN 315153

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20061127000175 NJ Practitioner - Family Practice 7719955954 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA08141800NJMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dennis Collaborative Care LLC Family Medicine Current
since Apr 1, 2017
Accepting new patients

Locations

901 W Main St
Freehold, NJ 07728
Phone (732) 294-2666

Interoperability endpoints

  • Direct secure messaging: pdennis425647@direct.ahsys.org

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25MA08141800 NJ Yes

Addresses

Primary practice location

17 Casino Dr
Farmingdale, NJ 07727-3701

Mailing address

17 Casino Dr
Farmingdale, NJ 07727-3701
Phone (270) 206-0069

Other providers in Farmingdale, NJ

All providers in Farmingdale, NJ · Family Medicine Physician in New Jersey

Sources for this page

Verify at the official NPI Registry.