Keep Glowing CT3
NPI 1912852104ActiveOrganization· Internal Medicine· Tinton Falls, NJ
Internal Medicine in Tinton Falls, New Jersey, registered in NPPES in March 2026. The authorized official on file is Michael Ellis, DO, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1912852104 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Mar 3, 2026 |
| Last updated in NPPES | Mar 3, 2026 |
| Certified by provider | Mar 3, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Internal Medicine Primary | 207R00000X | — | — |
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 Part B Supplier - Clinic/Group Practice (NJ) |
|---|
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