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FAMILY LEGACY MEDICAL CARE, PA
NPI 1043704810
Family Medicine in Elizabeth, NJ

Active since June 15, 2018
115 JEFFERSON AVE, ELIZABETH, NJ 07201(908) 351-6663(908) 351-1760 Get Directions Write a Review

NPPES record last updated: January 19, 2019. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Jan 19, 2019, Jun 15, 2018 (2 updates tracked since 2018).

About Family Legacy Medical Care, Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FAMILY LEGACY MEDICAL CARE, PA (NPI 1043704810) is a healthcare organization registered as a family medicine in Elizabeth, New Jersey and active in the NPI registry since June 2018. The organization maintains a secondary practice location in East Orange and lists Pascale Ferdinand, Physician, as its authorized official.

NPPES Registry Identity

NPI1043704810
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameFAMILY LEGACY MEDICAL CARE, PA
Location Address115 JEFFERSON AVEElizabeth, NJ 07201-2417
Mailing Address115 Jefferson AveElizabeth, NJ 07201-2417 · (908) 351-6663 · Fax (908) 351-1760
Phone(908) 351-6663
Fax(908) 351-1760
Organization SubpartNo
Authorized OfficialPascale FerdinandPhysician · (908) 351-6663
Enumeration DateJune 15, 2018
Last NPPES UpdateJanuary 19, 20192 updates tracked since enumeration
✔ NPI 1043704810 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
115 JEFFERSON AVE, Elizabeth, NJ 07201
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Secondary Practice Location 1

Location 160 Evergreen PlEast Orange, NJ 07018-2106 · Phone (973) 675-0097

Other Identifiers 2

Other10655985NJ · Caqh
Other14126510NJ · Caqh

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Family Legacy Medical Care, Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Family Legacy Medical Care, PA, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.

Clinicians, nearest first (2)

Michel-Ange Ferdinand, MD
General Practice
NPI 1770686289
115 JEFFERSON AVE
Elizabeth, NJ 07201
(908) 351-6663
✔ PECOS✔ Accepts MedicareSame address
Pascale Ferdinand, MD
Family Practice
NPI 1487067856
115 JEFFERSON AVE
Elizabeth, NJ 07201
(908) 447-7221
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Family Legacy Medical Care, PA's NPI number?

The NPI number for Family Legacy Medical Care, PA is 1043704810. It was assigned to this organization in the NPPES registry on June 15, 2018.

Where is Family Legacy Medical Care, PA located?

Family Legacy Medical Care, PA is located at 115 Jefferson Ave, Elizabeth, NJ 07201. The listed phone number is (908) 351-6663.

What is Family Legacy Medical Care, PA's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Family Legacy Medical Care, PA enrolled in Medicare?

Yes. Family Legacy Medical Care, PA is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Family Legacy Medical Care, PA?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Family Legacy Medical Care, PA, in Family Practice and General Practice. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Family Legacy Medical Care, PA was last updated on January 19, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.