Robert Marriott Medical Corp

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

ROBERT MARRIOTT MEDICAL CORP

Practice address

113 W Essex St
Maywood, NJ 07607-1023

Phone

(877) 878-3289

Fax

(877) 817-3227

NPI assigned

Oct 19, 2016

Organization subpart

Yes

Parent organization

ADVANTAGE WOUND CAREAs reported in NPPES

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

Authorized official

Name

Robert J Marriott, MD

Title

Ceo

Phone

(877) 878-3289

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ, CO2 enrollments

Enrollment records 2

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Robert Marriott Medical Corp

  • Surgery Physician
  • El Segundo, CA
  • NPI 1083883938

  O20090203000117, O20150501001748

  Same enrollment

Part of

Advantage Wound Care

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael H Bernstein, MD

  • Surgery Physician
  • Wayne, NJ
  • NPI 1073540613
  NPD
• Mikhail A Botvinov, D.O.

  • Surgery Physician
  • Westwood, NJ
  • NPI 1760685622
  NPD
• Frank Ciminello, MD

  • Plastic and Reconstructive Surgery Physician
  • Newark, NJ
  • NPI 1699746875
  NPD
• Ogori N Kalu, MD

  • Surgical Oncology Physician
  • Newark, NJ
  • NPI 1992942676

  Surgery

  NPD
• Robert M. Olson, M.D.

  • Plastic Surgery Physician
  • New Brunswick, NJ
  • NPI 1811906704
  NPD
• John L. Holup, D.O.

  • Surgery Physician
  • Williamsport, PA
  • NPI 1326010125
  NPD

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

{
    "created_epoch": "1476835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730073600000",
    "number": "1003367558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 N PACIFIC COAST HWY STE 2175",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902455639",
            "telephone_number": "877-878-3289",
            "fax_number": "877-817-3227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 W ESSEX ST",
            "city": "MAYWOOD",
            "state": "NJ",
            "postal_code": "076071023",
            "telephone_number": "877-878-3289",
            "fax_number": "877-817-3227"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2350 Hospital Rd",
            "address_purpose": "LOCATION",
            "city": "Allenwood",
            "state": "NJ",
            "postal_code": "087207037",
            "country_code": "US",
            "telephone_number": "877-878-3289",
            "fax_number": "877-817-3227",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ROBERT MARRIOTT MEDICAL CORP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ADVANTAGE WOUND CARE",
        "enumeration_date": "2016-10-19",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-28",
        "status": "A",
        "authorized_official_last_name": "MARRIOTT",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "877-878-3289",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0205052",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pooja Ragha, OTR/L
• Redirections, LLC
• Redirections, LLC
• Michel Reyes, RN
• Richard Kim M D LLC
• Sanjaykumar K Rudani, PHARMACIST
• Douglas Jay Saphier, M.D., MPH
• Catherine Sarmiento
• Randi A Sarokoff, PH.D., BCBA-D
• SBP Chiropractic PC

• Surgery Physician in Maywood, NJ
• Providers in Maywood, NJ by specialty
• Surgery Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.