Individual provider Active NPI

Erik J. Kobylarz, MD, PHD

  • Clinical Neurophysiology Physician
  • Lebanon, NH
National Provider Identifier
1003903188
Registry record updated Oct 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Neurophysiology PhysicianTaxonomy code 2084N0600X
License
14967 Issued in NH
Practice address
One Medical Center Drive
Dept. of Neurology, Dartmouth-Hitchcock Medical Center
Lebanon, NH 03756-0001
Phone
(603) 653-6118
Fax
(603) 650-6233
NPI assigned
Oct 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurocritical Care Physician 2084A2900X 14967 NH
Clinical Neurophysiology Physician 2084N0600X 14967 NH Primary
Neurology Physician 2084N0400X 14967 NH

Addresses

Primary practice location

One Medical Center Drive
Dept. of Neurology, Dartmouth-Hitchcock Medical Center
Lebanon, NH 03756-0001

Mailing address

One Medical Center Drive
Dept. of Neurology, Dartmouth-Hitchcock Medical Center
Lebanon, NH 03756-0001
Phone (603) 653-6118

Other identifiers 3

IdentifierTypeStateIssuer
02276933MedicaidNY
1017924MedicaidVT
30209789MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101020001022 NH Practitioner - Neurology 3779632351 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
79.66 of 100Reported as apm
Quality
53.51
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
79.66 of 100Reported as apm
Quality
53.51
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine, Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Dartmouth-Hitchcock Clinic CurrentSince Aug 4, 2010 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Aug 4, 2010 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Aug 4, 2010 Accepting new patients
Weill Medical College of Cornell Neurology Past Accepting new patients

Locations

1 Medical Dr
Lebanon, NH 03756
Phone (603) 650-5922

Interoperability endpoints

  • Direct secure messaging: ekobylarz14102@direct.dartmouth-hitchcock.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1160352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476403200000",
    "number": "1003903188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE MEDICAL CENTER DRIVE",
            "address_2": "DEPT. OF NEUROLOGY, DARTMOUTH-HITCHCOCK MEDICAL CENTER",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037560001",
            "telephone_number": "603-653-6118",
            "fax_number": "603-650-6233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ONE MEDICAL CENTER DRIVE",
            "address_2": "DEPT. OF NEUROLOGY, DARTMOUTH-HITCHCOCK MEDICAL CENTER",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037560001",
            "telephone_number": "603-653-6118",
            "fax_number": "603-650-6233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOBYLARZ",
        "first_name": "ERIK",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-09",
        "last_updated": "2016-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084A2900X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurocritical Care",
            "state": "NH",
            "license": "14967",
            "primary": false
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "NH",
            "license": "14967",
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NH",
            "license": "14967",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02276933",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1017924",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30209789",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, NH

Sources for this page

Verify at the official NPI Registry.