Individual provider Active NPI

Jack Francis Quinlan Jr., M.D.

  • Cardiovascular Disease Physician
  • Vineland, NJ
National Provider Identifier
1942460514
Registry record updated May 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
25MA08562300 Issued in NJ
Practice address
1076 E Chestnut Ave
1076 E Chestnut Ave
Vineland, NJ 08360-5843
Phone
(856) 692-7979
Fax
(856) 794-9479
NPI assigned
Jun 16, 2008
Last updated
May 22, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 25MA08562300 NJ Primary

Addresses

Primary practice location

1076 E Chestnut Ave
1076 E Chestnut Ave
Vineland, NJ 08360-5843

Mailing address

1076 E Chestnut Ave
Penn Cardiology Vineland
Vineland, NJ 08360-5843
Phone (856) 692-7979

Other identifiers 3

IdentifierTypeStateIssuer
1942460514OtherNJAMERIHEALTH
9077287OtherNJAETNA
P00833740OtherNJRAILROAD MEDICARE

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100211000273 NJ Practitioner - Cardiovascular Disease (Cardiology) 4789727819 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Rutgers New Jersey Medical School, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1076 E Chestnut St
Penn Cardiology Vineland Waxman Group
Vineland, NJ 08360-5843
Phone (856) 216-0300

211 S Main St
Suite 205
Cape May Court House, NJ 08210-2264
Phone (609) 463-0800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA08562300NJMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical Health Care Associates of New Jersey PC Cardiovascular Disease CurrentSince Nov 1, 2012 Accepting new patients
Clinical Health Care Associates of New Jersey, P.C. CurrentSince Nov 1, 2012 Accepting new patients

Locations

211 S Main St
Ste 205
Cape May Court House, NJ 08210
Phone (609) 463-0800

3205 Fire Rd
Egg Hbr Twp, NJ 08234
Phone (609) 407-1113

1076 E Chestnut Ave
Vineland, NJ 08360
Phone (609) 692-7979

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1213574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369180800000",
    "number": "1942460514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1076 E CHESTNUT AVE",
            "address_2": "PENN CARDIOLOGY VINELAND",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083605843",
            "telephone_number": "856-692-7979",
            "fax_number": "856-794-9479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1076 E CHESTNUT AVE",
            "address_2": "1076 E CHESTNUT AVE",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083605843",
            "telephone_number": "856-692-7979",
            "fax_number": "856-794-9479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUINLAN",
        "first_name": "JACK",
        "middle_name": "FRANCIS",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-16",
        "last_updated": "2013-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NJ",
            "license": "25MA08562300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "1942460514",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9077287",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00833740",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vineland, NJ

Sources for this page

Verify at the official NPI Registry.