Breynn Entwistle, PA-C

Primary specialty

Epilepsy PhysicianTaxonomy code 2084E0001X

License

25MP00483700 Issued in NJ

Practice address

479 County Road 520 Ste B101
Marlboro, NJ 07746-1089

Phone

(732) 856-5999

NPI assigned

Jul 2, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NV, NJ2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Barnabas Health Medical Group PC

  • Specialist
  • Elizabeth, NJ
  • NPI 1841557246

  NJ

  Medicare reassignment NPD
• Amor Mehta MD - Neurology Center for Epilepsy and Seizures, LLC

  • Epilepsy Physician
  • Marlboro, NJ
  • NPI 1174006233

  NJ

  Medicare reassignment
• University of Utah Adult Services

  • Clinical Cardiac Electrophysiology Physician
  • Ely, NV
  • NPI 1891172458

  NV

  Medicare reassignment
• Barnabas Health Medical Group PC

  • Durable Medical Equipment & Medical Supplies
  • Hackensack, NJ
  • NPI 1316772668
  NPD
• University of Utah Adult Services

  • Internal Medicine Physician
  • Elko, NV
  • NPI 1497280937
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1530489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729468800000",
    "number": "1003302183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 14TH AVE",
            "city": "BELMAR",
            "state": "NJ",
            "postal_code": "077192809",
            "telephone_number": "732-615-8951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "479 COUNTY ROAD 520 STE B101",
            "city": "MARLBORO",
            "state": "NJ",
            "postal_code": "077461089",
            "telephone_number": "732-856-5999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENTWISTLE",
        "first_name": "BREYNN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-02",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "10858311-1206",
            "primary": false
        },
        {
            "code": "2084E0001X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Epilepsy",
            "state": "NJ",
            "license": "25MP00483700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eihab Human Services New Jersey, Inc.
• Stuart Eisenberg, RPH
• Elf Services, LLC
• Karim Elsayed
• Empower U.
• Excel Endodontics
• Natalie Johanna Farah, PT, DPT
• Jocelyn Feintuch, OTR
• Mary Fensham, LCSW
• Michael John Ferra, M.D.

• All providers in Marlboro, NJ
• Epilepsy Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.