DR. PAUL J DEMARTINO MD
NPI 1922104827
Internal Medicine - Gastroenterology in Toms River, NJ

Q: What is Paul Demartino's NPI number?

The NPI number for Paul Demartino is 1922104827. It was assigned to this individual provider in the NPPES registry on September 16, 2006.

Q: What is Paul Demartino's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Q: When was this NPI record last updated?

The NPPES record for Paul Demartino was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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 September 16, 2006PECOS EnrolledAccepts Medicare Assignment

25.96/100

CMS Quality Rating

368 LAKEHURST RD, SUITE 205, TOMS RIVER, NJ 08755(732) 914-8282(732) 914-8285 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: September 06, 2026.

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About Dr. Paul J Demartino Md NPPES

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

DR. PAUL J DEMARTINO MD (NPI 1922104827) is an individual gastroenterology provider in Toms River, New Jersey, licensed in New Jersey (MA59618) and active in the NPI registry since September 2006. He is enrolled in Medicare PECOS, is affiliated with Community Medical Center, and is a graduate of Rutgers R W Johnson Medical School (cam/new Bruns/pisc) (1988).

NPPES Registry Identity

NPI1922104827

Entity TypeIndividualMale

Primary Taxonomy207RG0100X

Provider Legal NameDR. PAUL J DEMARTINOCredential: MD

Location Address368 LAKEHURST RD, SUITE 205Toms River, NJ 08755

Mailing Address368 Lakehurst Rd, Suite 205Toms River, NJ 08755 · (732) 914-8282 · Fax (732) 914-8285

Phone(732) 914-8282

Fax(732) 914-8285

Sole ProprietorNo

Medical School CMSRutgers R W Johnson Medical School (cam/new Bruns/pisc)Graduated 1988

Enumeration DateSeptember 16, 2006

Last NPPES UpdateJuly 8, 2007

✔ NPI 1922104827 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians

Taxonomy Code207RG0100X

License✔ Licensed in NJ · MA59618

Definition

An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.

368 LAKEHURST RD, Toms River, NJ 08755

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Other Identifiers 2

Medicare ID-Type Unspecified035629DDDNJ

Medicare UPINE83873

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Paul J Demartino Md 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 ID4183713936

PECOS Enrollment IDI20110325000759

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.

Areas of Expertise CMS Part B claims 15

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.

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.

1,384 services629 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

351 services297 patients

Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239

This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.

233 services217 patients

New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

195 services195 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.

147 services60 patients

Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385

This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.

96 services94 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.

83 services69 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.

77 services38 patients

Diagnostic exam of large bowel using a flexible endoscope 45378

This procedure, known as a colonoscopy, involves using a flexible tube with a light and camera to examine the large intestine. It helps detect any abnormalities such as polyps or inflammation. It's a standard procedure to ensure gut health.

71 services71 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.

68 services66 patients

Biopsy of large bowel using a flexible endoscope 45380

A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.

52 services52 patients

Removal of polyps or growths of esophagus, stomach, and/or upper small bowel using an endoscope with mechanical snare 43251

This procedure involves the use of a thin, flexible instrument called an endoscope to visualize and remove abnormal growths, known as polyps, from the esophagus, stomach, or upper small bowel. A tool called a mechanical snare is used to safely cut and remove these growths.

45 services45 patients

Critical care, first 30-74 minutes 99291

Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.

40 services18 patients

Balloon dilation of esophagus, stomach, and/or upper small bowel using a flexible endoscope, less than 3.0 cm 43249

This procedure involves using a flexible tube with a camera, called an endoscope, to gently expand narrowed areas in your esophagus, stomach, or upper small bowel. A small balloon is inflated, making it easier for food and liquid to pass through. It's safe and effective.

32 services29 patients

Dilation of esophagus 43450

Dilation of the esophagus is a procedure aimed to stretch or open up your esophagus (the tube connecting your mouth to your stomach) when it's narrow. It helps to improve swallowing and alleviate discomfort. It's typically performed using a flexible tube or balloon, under sedation.

14 services14 patients

Hospital Affiliations CMS Care Compare

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

Community Medical Center

Acute Care Hospitals · Toms River, NJ

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310041

Location99 Rt 37 WestToms River, NJ 08755 · Ocean County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 08755 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

$107.94 typical visit price

range $20.08 – $150.98

Typical copayment $26.98 (range $5.02 – $37.74)

Most-billed visit code 99214

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.

25.96/100

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

Individually scored

Quality

Improvement Activities

Cost

86.54

Reported Quality Measures

Colorectal Cancer Screening

Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer

9%655 patients1/55-star benchmark: 85%

Documentation of Current Medications in the Medical Record

Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.

45%1,523 patients1/55-star benchmark: 100%

e-Prescribing

At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.

99%234 patients4/55-star benchmark: 100%

Medication Reconciliation

The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.

55%2,264 patients1/55-star benchmark: 100%

Patient-Specific Education

The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.

57%1,548 patients3/55-star benchmark: 99%

Pneumococcal Vaccination Status for Older Adults

Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine

1%703 patients1/55-star benchmark: 90%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…

25%1,159 patients2/55-star benchmark: 97%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user

Patients tobacco: 24% · 561 patients

28%561 patients

Provide Patient Access

At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…

59%1,548 patients3/55-star benchmark: 100%

Use of High-Risk Medications in the Elderly

Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.

Lower rates are better for this measure.

Patients 2+: 0% · 703 patients

0%703 patients5/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 20

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

NATASHA M RAO MSOT OTR

Occupational Therapist

368 LAKEHURST RD
TOMS RIVER, NJ 08755

Ocean County (888) 244-5373

MS. JAMIE LYNN CONNER LPC

Counselor (Professional)

368 LAKEHURST RD
TOMS RIVER, NJ 08755

Ocean County (732) 245-8343

DR. TITHI MITRA MD

Internal Medicine

368 LAKEHURST RD, SUITE 207
TOMS RIVER, NJ 08755

Ocean County (732) 557-6222

DR. LARAINE MALVINO DPT

Physical Therapist

368 LAKEHURST RD, SUITE 202
TOMS RIVER, NJ 08755

Ocean County (732) 914-8500

KESSLER INSTITUTE FOR REHABILITATION INC

Clinic/Center (Physical Therapy)

368 LAKEHURST RD, STE 202
TOMS RIVER, NJ 08755

Ocean County (732) 914-8500

CARDIOLOGY CONSULTANTS OF TOMS RIVER, PA

Internal Medicine (Cardiovascular Disease)

368 LAKEHURST RD, SUITE 301
TOMS RIVER, NJ 08755

Ocean County (732) 240-1048

NICOLE KATRI MS, OTR/L

Occupational Therapist (Pediatrics)

368 LAKEHURST RD
TOMS RIVER, NJ 08755

Ocean County (888) 244-5373

JOHN MALONEY

Physical Therapist

368 LAKEHURST RD, SUITE 202
TOMS RIVER, NJ 08755

Ocean County (732) 914-8500

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 Paul Demartino's NPI number?

The NPI number for Paul Demartino is 1922104827. It was assigned to this individual provider in the NPPES registry on September 16, 2006.

Where is Paul Demartino located?

Paul Demartino practices at 368 Lakehurst Rd Suite 205, Toms River, NJ 08755. The listed phone number is (732) 914-8282.

What is Paul Demartino's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Is Paul Demartino enrolled in Medicare?

Yes. Paul Demartino 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.

Is Paul Demartino affiliated with any hospitals?

According to CMS data, Paul Demartino is affiliated with Community Medical Center.

When was this NPI record last updated?

The NPPES record for Paul Demartino was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.