THE ESTAUGH T/A MEDFORD LEAS
NPI 1659309524
Family Medicine - Geriatric Medicine in Medford, NJ

Q: What is The Estaugh T/A Medford Leas's NPI number?

The NPI number for The Estaugh T/A Medford Leas is 1659309524. It was assigned to this organization in the NPPES registry on June 29, 2006.

Q: What is The Estaugh T/A Medford Leas's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Geriatric Medicine, with taxonomy code 207QG0300X.

Active since June 29, 2006

1 MEDFORD LEAS, MEDFORD, NJ 08055(609) 654-3005(609) 654-7894 Get Directions Write a Review

NPPES record last updated: July 15, 2022. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jul 15, 2022, May 12, 2021, Nov 14, 2016 (3 updates tracked since 2016).

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About The Estaugh T/a Medford Leas NPPES

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

THE ESTAUGH T/A MEDFORD LEAS (NPI 1659309524) is a healthcare organization registered as a geriatric medicine in Medford, New Jersey and active in the NPI registry since June 2006. The organization lists Jeremy M Vickers, Chief Executive Officer, as its authorized official.

NPPES Registry Identity

NPI1659309524

Entity TypeOrganization

Primary Taxonomy207QG0300X

Legal Business NameTHE ESTAUGH T/A MEDFORD LEAS

Location Address1 MEDFORD LEASMedford, NJ 08055-2254

Mailing Address1 Medford LeasMedford, NJ 08055-2254 · (609) 654-3005 · Fax (609) 654-7894

Phone(609) 654-3005

Fax(609) 654-7894

Organization SubpartNo

Authorized OfficialJeremy M VickersChief Executive Officer · (609) 654-3009

Enumeration DateJune 29, 2006

Last NPPES UpdateJuly 15, 20223 updates tracked since enumeration

NPPES CertifiedJuly 15, 2022

✔ NPI 1659309524 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily Medicine · Geriatric MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207QG0300X

Definition

A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital.

1 MEDFORD LEAS, Medford, NJ 08055

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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)

The Estaugh T/a Medford Leas is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 4 clinicians reassign Medicare billing to The Estaugh T/A Medford Leas, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 4 within 10 miles. They are listed nearest first.

Clinicians, nearest first (4)

James Damico, DO

Internal Medicine

NPI 1457353088

1 MEDFORD LEAS
Medford, NJ 08055

(609) 654-3427

✔ PECOS✔ Accepts MedicareSame address

Jeffrey Ranalli, D.O.

Internal Medicine

NPI 1639120462

1 MEDFORD LEAS
Medford, NJ 08055

(609) 654-3427

✔ PECOS✔ Accepts MedicareSame address

Terry Fazio, NP

Nurse Practitioner

NPI 1720253743

1 MEDFORD LEAS
Medford, NJ 08055

(609) 654-3427

✔ PECOS✔ Accepts Medicare0.2 mi

Loren Firstenberg, PSY.D

Clinical Psychologist

NPI 1033231873

1205 N CHURCH ST
Moorestown, NJ 08057

(856) 778-0600

✔ PECOS✔ Accepts Medicare9.2 mi

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 The Estaugh T/A Medford Leas's NPI number?

The NPI number for The Estaugh T/A Medford Leas is 1659309524. It was assigned to this organization in the NPPES registry on June 29, 2006.

Where is The Estaugh T/A Medford Leas located?

The Estaugh T/A Medford Leas is located at 1 Medford Leas, Medford, NJ 08055. The listed phone number is (609) 654-3005.

What is The Estaugh T/A Medford Leas's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Geriatric Medicine, with taxonomy code 207QG0300X.

Is The Estaugh T/A Medford Leas enrolled in Medicare?

Yes. The Estaugh T/A Medford Leas is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through The Estaugh T/A Medford Leas?

According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians reassign their Medicare billing to The Estaugh T/A Medford Leas, in Clinical Psychologist, Internal Medicine and Nurse Practitioner. 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 and 4 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for The Estaugh T/A Medford Leas was last updated on July 15, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.