Individual provider Active NPI

Daniel Notterman

  • Pediatric Critical Care Medicine Physician
  • New Brunswick, NJ
National Provider Identifier
1013077890
Registry record updated May 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
License
25MA03948900 Issued in NJ
Practice address
1 Robert Wood Johnson PL
Robert Wood Johnson University Hospital - New Brunswick
New Brunswick, NJ 08901-1928
Phone
(732) 235-7900
NPI assigned
Dec 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 25MA03948900 NJ
Pediatric Critical Care Medicine Physician 2080P0203X 25MA03948900 NJ Primary

Addresses

Primary practice location

1 Robert Wood Johnson PL
Robert Wood Johnson University Hospital - New Brunswick
New Brunswick, NJ 08901-1928

Mailing address

66 W Gilbert St
2ND Floor
Tinton Falls, NJ 07701-4947
Phone (732) 212-0051

Other identifiers 1

IdentifierTypeStateIssuer
1857908MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20170221002258 NJ Practitioner - Pediatric Medicine 1557672573 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Rutgers Health-RWJ Scleroderma Program Current Accepting new patients
Rutgers Health-RWJ Pediatric Critical Care CurrentSince Feb 1, 2021 Accepting new patients
Rutgers Health-RWJ Primary Medicine Group Current Accepting new patients
Rutgers Health-RWJ Primary Medicine Group CurrentSince Feb 1, 2021 Accepting new patients
Rutgers Health-RWJ Primary Medicine Group Pediatrics CurrentSince Dec 10, 2016 Accepting new patients
Rutgers Health-RWJ Scleroderma Program Current Accepting new patients

Locations

125 Paterson St
#104
New Brunswick, NJ 08901
Phone (609) 655-5175

125 Paterson St
New Brunswick, NJ 08901
Phone (732) 235-6511

125 Paterson St
Ste 5100A
New Brunswick, NJ 08901
Phone (609) 655-5175

1 Rwj Pl
New Brunswick, NJ 08901
Phone (732) 235-7887

125 Paterson St
Ste 6140
New Brunswick, NJ 08901
Phone (732) 235-6230

1 Worlds Fair Dr
Somerset, NJ 08873
Phone (732) 235-7775

1 Worlds Fair Dr
Fl 1
Somerset, NJ 08873
Phone (732) 235-7894

66 W Gilbert St
Fl 2
Tinton Falls, NJ 07701
Phone (732) 212-0051

Organizations & group practices 6

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": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714694400000",
    "number": "1013077890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 W GILBERT ST",
            "address_2": "2ND FLOOR",
            "city": "TINTON FALLS",
            "state": "NJ",
            "postal_code": "077014947",
            "telephone_number": "732-212-0051",
            "fax_number": "732-212-0713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ROBERT WOOD JOHNSON PL",
            "address_2": "ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL - NEW BRUNSWICK",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089011928",
            "telephone_number": "732-235-7900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOTTERMAN",
        "first_name": "DANIEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2024-05-03",
        "certification_date": "2024-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA03948900",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "NJ",
            "license": "25MA03948900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1857908",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Brunswick, NJ

Sources for this page

Verify at the official NPI Registry.