Edwin J. Custodio, APN
NPI 1174318844ActiveIndividual· Nurse Practitioner, Family· Hammonton, NJ
Nurse Practitioner, Family (APN) with Southern Jersey Family Medical Centers, Inc, practicing in Hammonton, New Jersey. Enrolled in Medicare as practitioner - nurse practitioner.
Overview
| NPI | 1174318844 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | APN |
| Sole proprietor | Yes |
| NPI issued | Apr 11, 2025 |
| Last updated in NPPES | Apr 28, 2026 |
| Certified by provider | Apr 28, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Family Primary | 363LF0000X | 26NJ15527500 | NJ |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Nurse Practitioner (NJ) |
|---|
Education and affiliations
| Graduation year | 2025 |
|---|---|
| Medicare specialty | Nurse Practitioner |
Medical group
- Southern Jersey Family Medical Centers, IncAtlantic City, NJ · 42 clinicians
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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