Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

MYSTIC ISLAND PEDIATRIC ASSOCIATES, LLC
NPI 1679892533
Clinic/Center - Medical Specialty in Little Egg Harbor Twp, NJ

Q: What is Mystic Island Pediatric Associates, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Medical Specialty, with taxonomy code 261QM2500X.

Active since May 18, 2010CLIA 31D1046272 · Waiver

1387 ROUTE 539 UNIT 2C, LITTLE EGG HARBOR TWP, NJ 08087(609) 296-1900(609) 296-1906 Get Directions Write a Review

NPPES record last updated: September 4, 2026. Verified against the NPPES registry weekly; last sync: September 06, 2026.

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About Mystic Island Pediatric Associates, Llc NPPES

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

MYSTIC ISLAND PEDIATRIC ASSOCIATES, LLC (NPI 1679892533) is a healthcare organization registered as a medical specialty in Little Egg Harbor Twp, New Jersey and active in the NPI registry since May 2010. The organization holds a CLIA Waiver certificate valid through October 4, 2027 and lists Gene Chiu Lee, Vp, as its authorized official.

NPPES Registry Identity

NPI1679892533

Entity TypeOrganization

Primary Taxonomy261QM2500X

Legal Business NameMYSTIC ISLAND PEDIATRIC ASSOCIATES, LLC

Location Address1387 ROUTE 539 UNIT 2CLittle Egg Harbor Twp, NJ 08087-9804

Mailing Address1387 Route 539 Unit 2cLittle Egg Harbor Twp, NJ 08087-9804 · (609) 296-1900 · Fax (609) 296-1906

Phone(609) 296-1900

Fax(609) 296-1906

Organization SubpartNo

Authorized OfficialGene Chiu LeeVp · (609) 294-5500

Enumeration DateMay 18, 2010

Last NPPES UpdateSeptember 4, 2026

NPPES CertifiedSeptember 4, 2026

✔ NPI 1679892533 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Medical SpecialtyAmbulatory Health Care Facilities

Taxonomy Code261QM2500X

License✔ Licensed in NJ · 25MA05073700

Definition

An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).

1387 ROUTE 539 UNIT 2C, Little Egg Harbor Twp, NJ 08087

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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 31D1046272

Mystic Island Pediatrics Associates LLC · Little Egg Harbor Twp, NJ

Active · expires Oct 4, 2027

CLIA Number31D1046272

Laboratory TypePhysician Office

Certificate Effective DateOctober 5, 2025

Certificate Expiration DateOctober 4, 2027

Laboratory DirectorErika Humphreys

Laboratory Phone(609) 296-1900

Laboratory LocationMystic Island Pediatrics Associates LLC1387 Route 539 Suite 2C, Little Egg Harbor Twp, NJ 08087

CLIA data matches this NPI record on: Address Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

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

INNOUT UROLOGY OFFICE

Nurse Practitioner (Family)

1387 ROUTE 539 UNIT 2C
LITTLE EGG HARBOR TWP, NJ 08087

Ocean County (888) 433-9360

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 Mystic Island Pediatric Associates, LLC's NPI number?

The NPI number for Mystic Island Pediatric Associates, LLC is 1679892533. It was assigned to this organization in the NPPES registry on May 18, 2010.

Where is Mystic Island Pediatric Associates, LLC located?

Mystic Island Pediatric Associates, LLC is located at 1387 Route 539 Unit 2C, Little Egg Harbor Twp, NJ 08087. The listed phone number is (609) 296-1900.

What is Mystic Island Pediatric Associates, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Medical Specialty, with taxonomy code 261QM2500X.

Does Mystic Island Pediatric Associates, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 31D1046272) is associated with this NPI, valid through October 4, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Mystic Island Pediatric Associates, LLC was last updated on September 4, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 days 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.