CHARLES P FERNICOLA M.D.
NPI 1063472694
Urology in Manahawkin, NJ

Q: What is Charles Fernicola's NPI number?

The NPI number for Charles Fernicola is 1063472694. It was assigned to this individual provider in the NPPES registry on March 27, 2006.

Q: What is Charles Fernicola's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Q: When was this NPI record last updated?

The NPPES record for Charles Fernicola was last updated on March 14, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.

Active since March 27, 2006PECOS EnrolledAccepts Medicare Assignment

75.8/100

CMS Quality Rating

1145 BEACON AVE, MANAHAWKIN, NJ 08050(609) 597-1991(609) 597-8198 Get Directions Write a Review

NPPES record last updated: March 14, 2014. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Charles P Fernicola M.d. NPPES

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

CHARLES P FERNICOLA M.D. (NPI 1063472694) is an individual urology provider in Manahawkin, New Jersey, licensed in New Jersey (25MA04460500) and active in the NPI registry since March 2006. He is enrolled in Medicare PECOS, is affiliated with Jersey Shore University Medical Center, and is a graduate of Rutgers New Jersey Medical School (1982).

NPPES Registry Identity

NPI1063472694

Entity TypeIndividualMale

Primary Taxonomy208800000X

Provider Legal NameCHARLES P FERNICOLACredential: M.D.

Location Address1145 BEACON AVEManahawkin, NJ 08050-2471

Mailing Address1145 Beacon AveManahawkin, NJ 08050-2471 · (609) 597-1991 · Fax (609) 597-8198

Phone(609) 597-1991

Fax(609) 597-8198

Sole ProprietorNo

Medical School CMSRutgers New Jersey Medical SchoolGraduated 1982

Enumeration DateMarch 27, 2006

Last NPPES UpdateMarch 14, 2014

✔ NPI 1063472694 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyUrologyAllopathic & Osteopathic Physicians

Taxonomy Code208800000X

License✔ Licensed in NJ · 25MA04460500

Definition

A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.

1145 BEACON AVE, Manahawkin, NJ 08050

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Other Identifiers 2

Medicaid3131602NJ

Medicare UPINC59866NJ

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware, Oscar Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Charles P Fernicola M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4981647120

PECOS Enrollment IDI20050608000345

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Charles Fernicola reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Hackensack Meridian Health Medical Group - Specialty Care PC

43 mi

Surgical Critical Care

331 NEWMAN SPRINGS RD STE 220
Red Bank, NJ 07701

Reassigned Medicare billing, New Jersey enrollment
2,844 clinicians in this Medicare group

NPI 1215989249 (732) 807-0800

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

Areas of Expertise CMS Part B claims 23

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Injection, denosumab, 1 mg J0897

Denosumab is a medication given via injection to strengthen your bones. It works by slowing down the cells that break down bone, improving bone density and reducing the risk of fractures. It's often used for osteoporosis treatment.

1,503 services13 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

822 services580 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

291 services256 patients

Injection, triptorelin pamoate, 3.75 mg J3315

Triptorelin pamoate 3.75 mg is a medication administered via injection. It helps regulate certain hormone levels in your body, managing various health conditions. It's important to follow your doctor's instructions for this treatment.

141 services23 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

118 services91 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

86 services58 patients

Diagnostic exam of bladder and urethra using an endoscope 52000

This procedure involves using a thin, flexible tube with a light, called an endoscope, to examine the bladder and urethra. It helps in identifying any abnormalities or issues that may be causing discomfort or other symptoms.

78 services62 patients

Injection of drug or substance under skin or into muscle 96372

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

61 services30 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

54 services52 patients

Shock wave crushing of kidney stones 50590

Shock wave crushing of kidney stones, also known as Extracorporeal Shock Wave Lithotripsy (ESWL), is a non-invasive treatment. It involves the use of sound waves to break down kidney stones into small pieces that can easily pass through your urinary tract.

30 services27 patients

Ultrasound measurement of bladder capacity after voiding 51798

Ultrasound measurement of bladder capacity after voiding is a non-invasive test that uses sound waves to create images of your bladder. It's done after you've emptied your bladder to see if there's any leftover urine, which can help diagnose certain conditions.

30 services28 patients

Simple change of bladder tube 51705

A simple change of bladder tube involves replacing your current urinary drainage tube with a new one. This is done to maintain hygiene and prevent infections. It's a straightforward process, usually causing minimal discomfort, and helps ensure your body can properly dispose of waste fluids.

28 services15 patients

Imaging of urinary tract following injection of a contrast agent 74420

This procedure involves injecting a contrast agent into your body to help highlight the urinary tract during imaging. The contrast agent makes your urinary tract more visible on the images, providing detailed information about its structure and function. This can help in diagnosing any potential issues.

27 services20 patients

Urinalysis, manual test 81002

A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.

26 services26 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

25 services25 patients

Administration of hormonal anti-neoplastic chemotherapy under skin or into muscle 96402

This procedure involves the injection of hormone-based anti-cancer drugs under the skin or into a muscle. These medications help to slow down or stop the growth of certain types of cancer cells. The process is usually quick and can be performed in a clinic or hospital.

23 services14 patients

Simple insertion of temporary bladder tube 51702

This procedure involves placing a temporary tube into your bladder to help with urine flow. It's done when the body can't naturally remove urine. The tube is inserted through a small opening and allows urine to drain into a bag. It's usually a short-term solution.

22 services13 patients

Insertion of stent in ureter using an endoscope 52332

This procedure involves placing a small, flexible tube (stent) in your body's drainage system to help urine flow from the kidneys to the bladder. An endoscope, a thin tube with a light and camera, is used for precise placement.

20 services17 patients

Ultrasound scan of pelvic region through rectum 76872

An ultrasound scan of the pelvic region through the rectum is a medical procedure where a small, smooth device is gently inserted into the rectum. This device uses sound waves to create images of the internal structures in the lower abdomen, aiding in diagnosis and treatment planning.

14 services12 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

14 services14 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

14 services12 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

12 services12 patients

Biopsy of prostate gland 55700

A biopsy of the prostate gland is a procedure where a small sample of tissue is taken from your body's internal gland, located near the bladder, for testing. This helps in diagnosing potential health issues. It's usually done with a fine needle and imaging technology for accuracy.

11 services11 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Jersey Shore University Medical Center

Acute Care Hospitals · Neptune, NJ

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310073

Location1945 State Route 33Neptune, NJ 07753 · Monmouth County

Emergency services Birthing friendly

Southern Ocean Medical Center

Acute Care Hospitals · Manahawkin, NJ

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310113

Location1140 Rt 72 WManahawkin, NJ 08050 · Ocean County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 08050 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$140.34 typical visit price

range $61.59 – $185.05

Typical copayment $35.08 (range $15.39 – $46.26)

Most-billed visit code 99204

Established Patient

$76.45 typical visit price

range $20.08 – $150.98

Typical copayment $19.11 (range $5.02 – $37.74)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

75.8/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

68.65

Promoting Interoperability

100

Improvement Activities

Cost

50.69

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each A4351

DME-Orthotic Devices · category DF008N

2 suppliers11 claims2,548 services$1.64 avg. paid by Medicare

Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each A4357

DME-Orthotic Devices · category DF000N

5 suppliers21 claims68 services$8.85 avg. paid by Medicare

Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each A4358

DME-Orthotic Devices · category DF000N

3 suppliers11 claims48 services$6.38 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CHARLES P FERNICOLA MD PC

Urology

1145 BEACON AVE
MANAHAWKIN, NJ 08050

Ocean County (609) 597-1991

MICHAEL A PISKUN M.D.

Urology

1145 BEACON AVE, STE A
MANAHAWKIN, NJ 08050

Ocean County (609) 597-1991

TODD JERRY LEHRFELD MD

Urology

1145 BEACON AVE, STE A
MANAHAWKIN, NJ 08050

Ocean County (609) 597-1991

MR. GREGORY JOHN MAZZATTA DPM

Podiatrist

1145 BEACON AVE
MANAHAWKIN, NJ 08050

Ocean County (609) 597-6688

DR. MARC FEDER M.D.

Urology

1145 BEACON AVE, STE A
MANAHAWKIN, NJ 08050

Ocean County (609) 597-1991

TERI L FALCONER PAC

Physician Assistant

1145 BEACON AVE
MANAHAWKIN, NJ 08050

Ocean County (609) 597-7110

MR. JEFFREY ALBERT MAZZATTA DPM

Podiatrist (Foot & Ankle Surgery)

1145 BEACON AVE
MANAHAWKIN, NJ 08050

Ocean County (609) 597-6688

MRS. LAUREN ROSE SERNOTTI P.A.-C

Physician Assistant

1145 BEACON AVE
MANAHAWKIN, NJ 08050

Ocean County (609) 597-1991

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 Charles Fernicola's NPI number?

The NPI number for Charles Fernicola is 1063472694. It was assigned to this individual provider in the NPPES registry on March 27, 2006.

Where is Charles Fernicola located?

Charles Fernicola practices at 1145 Beacon Ave, Manahawkin, NJ 08050. The listed phone number is (609) 597-1991.

What is Charles Fernicola's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Is Charles Fernicola enrolled in Medicare?

Yes. Charles Fernicola is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Charles Fernicola's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Charles Fernicola reassigns Medicare benefits to Hackensack Meridian Health Medical Group - Specialty Care PC (Red Bank, NJ). The 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 Charles Fernicola's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Charles Fernicola accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Oscar Health list Charles Fernicola as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Charles Fernicola affiliated with any hospitals?

According to CMS data, Charles Fernicola is affiliated with Jersey Shore University Medical Center and Southern Ocean Medical Center.

When was this NPI record last updated?

The NPPES record for Charles Fernicola was last updated on March 14, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.