DR. EMMET THEODORE FENICHEL M.D.
NPI 1952832164
Family Medicine in Middletown, NJ

Q: What is Emmet Fenichel's NPI number?

The NPI number for Emmet Fenichel is 1952832164. It was assigned to this individual provider in the NPPES registry on March 21, 2017.

Q: What is Emmet Fenichel's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Emmet Fenichel was last updated on July 16, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since March 21, 2017PECOS EnrolledAccepts Medicare Assignment

94.95/100

CMS Quality Rating

18 LEONARDVILLE RD, MIDDLETOWN, NJ 07748(732) 671-0860 Get Directions Write a Review

NPPES record last updated: July 16, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jul 16, 2020, Mar 21, 2017 (2 updates tracked since 2017).

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About Dr. Emmet Theodore Fenichel M.d. NPPES

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

DR. EMMET THEODORE FENICHEL M.D. (NPI 1952832164) is an individual family medicine provider in Middletown, New Jersey, licensed in New Jersey (25MA10649000) and active in the NPI registry since March 2017. He is enrolled in Medicare PECOS, is affiliated with Riverview Medical Center, and is a graduate of Other (2016).

NPPES Registry Identity

NPI1952832164

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameDR. EMMET THEODORE FENICHELCredential: M.D.

Location Address18 LEONARDVILLE RDMiddletown, NJ 07748-2311

Mailing Address18 Leonardville RdMiddletown, NJ 07748-2311 · (732) 671-0860 · Fax (732) 671-6467

Phone(732) 671-0860

Sole ProprietorNo

Medical School CMSOtherGraduated 2016

Enumeration DateMarch 21, 2017

Last NPPES UpdateJuly 16, 20202 updates tracked since enumeration

NPPES CertifiedJuly 16, 2020

✔ NPI 1952832164 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in NJ · 25MA10649000

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.

18 LEONARDVILLE RD, Middletown, NJ 07748

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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. Emmet Theodore Fenichel 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 ID9830448620

PECOS Enrollment IDI20200917000287

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 13

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.

327 services217 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.

74 services67 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

71 services71 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 services12 patients

Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg J3420

This is a procedure where a small dose of Vitamin B-12, also known as Cyanocobalamin, is injected into your body. This vitamin is essential for nerve function and the production of red blood cells. It's often used to treat vitamin B-12 deficiency.

60 services11 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.

58 services42 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

52 services51 patients

Telephone medical discussion with physician, 21-30 minutes 99443

This service involves a 21-30 minute phone conversation with a physician. It's a chance for you to discuss your health concerns, symptoms or treatment plans. It's similar to an in-person consultation, but conducted over the phone for your convenience and safety.

37 services27 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.

34 services34 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

33 services33 patients

Influenza vaccine split virus, preservative free 90662

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

32 services32 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.

28 services28 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.

23 services23 patients

Hospital Affiliations CMS Care Compare 4

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

Riverview Medical Center

Acute Care Hospitals · Red Bank, NJ

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310034

LocationOne Riverview PlazaRed Bank, NJ 07701 · Monmouth County

Emergency services Birthing friendly

Ocean Medical Center

Acute Care Hospitals · Brick, NJ

3/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number310052

Location425 Jack Martin BlvdBrick, NJ 08724 · Ocean County

Emergency services Birthing friendly

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 07748 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

$94.90 typical visit price

range $61.59 – $185.05

Typical copayment $23.72 (range $15.39 – $46.26)

Most-billed visit code 99203

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.

94.95/100

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

Scored through an Alternative Payment Model

Quality

87.26

Promoting Interoperability

100

Improvement Activities

Other Providers at the Same Location NPPES 10

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

DIANNE H. DRUM AGNP

Nurse Practitioner (Primary Care)