NPIMap

Individual provider Active NPI

Emmet Theodore Fenichel, M.D.

  • Family Medicine Physician
  • Middletown, NJ
National Provider Identifier
1952832164
Registry record updated Jul 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MA10649000 Issued in NJ
Practice address
18 Leonardville Rd
Middletown, NJ 07748-2311
Phone
(732) 671-0860
NPI assigned
Mar 21, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25MA10649000 NJ Primary

Addresses

Primary practice location

18 Leonardville Rd
Middletown, NJ 07748-2311

Mailing address

18 Leonardville Rd
Middletown, NJ 07748-2311
Phone (732) 671-0860

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200917000287 NJ Practitioner - Family Practice 9830448620 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hackensack Meridian Health Medical Group - Primary Care PCGroup PAC ID 7911003330, 364 clinicians

Practice addresses (Care Compare)

1515 Richmond Ave
Point Pleasant Boro, NJ 08742-3056
Phone (732) 295-0072

Hospital & facility affiliations

  • Hackensack Meridian at Home Ocean County Home health agency, Brick, NJ, CCN 317075
  • Ocean Medical Center Hospital, Brick, NJ, CCN 310052
  • Jersey Shore University Medical Center Hospital, Neptune, NJ, CCN 310073
  • Southern Ocean Medical Center Hospital, Manahawkin, NJ, CCN 310113
  • Riverview Medical Center Hospital, Red Bank, NJ, CCN 310034

Merit-based Incentive Payment System (MIPS)

Final score
96.09 of 100Reported as apm
Quality
86.89
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA10649000NJMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hackensack Meridian Health Medical Group - Primary Care PC Family Medicine CurrentSince Nov 15, 2022 Accepting new patients
Ima Urgent Care Past Accepting new patients

Locations

985 Cedar Bridge Ave
Brick, NJ 08723
Phone (732) 477-5600

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

1515 Richmond Ave
Point Pleasant Boro, NJ 08742
Phone (732) 295-0072

Interoperability endpoints

  • FHIR API: https://mepic.hmhn.org/fhir/api/FHIR/R4/
  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.71872

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.

Hospital & facility affiliations 9

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": "1490054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594857600000",
    "number": "1952832164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 LEONARDVILLE RD",
            "city": "MIDDLETOWN",
            "state": "NJ",
            "postal_code": "077482311",
            "telephone_number": "732-671-0860",
            "fax_number": "732-671-6467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 LEONARDVILLE RD",
            "city": "MIDDLETOWN",
            "state": "NJ",
            "postal_code": "077482311",
            "telephone_number": "732-671-0860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENICHEL",
        "first_name": "EMMET",
        "middle_name": "THEODORE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-21",
        "last_updated": "2020-07-16",
        "certification_date": "2020-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA10649000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, NJ

Sources for this page

Verify at the official NPI Registry.