Individual provider Active NPI

Fred A Kobylarz, MD, MPH

  • Geriatric Medicine (Family Medicine) Physician
  • Monroe Township, NJ
National Provider Identifier
1023110749
Registry record updated Apr 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
25MA0628900 Issued in NJ
Practice address
18 Centre Dr
Monroe Township, NJ 08831-1501
Phone
(609) 655-5178
Fax
(609) 655-5284
NPI assigned
Sep 2, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25MA0628900 NJ
Geriatric Medicine (Family Medicine) Physician 207QG0300X 29924 IA
Geriatric Medicine (Family Medicine) Physician 207QG0300X ME90906 FL
Geriatric Medicine (Family Medicine) Physician 207QG0300X 25MA0628900 NJ Primary

Addresses

Primary practice location

18 Centre Dr
Monroe Township, NJ 08831-1501

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
6933904MedicaidNJ

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
I20081230000215 NJ Practitioner - Family Practice 0941362941 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rutgers Health-PCC Monument SquareGroup PAC ID 1052389582, 39 clinicians

Practice addresses (Care Compare)

317 George St
Suite 100
New Brunswick, NJ 08901-2047
Phone (732) 235-6200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA0628900NJMDFamily Medicine Physician
ME90906FLMDGeriatric Medicine (Family Medicine) Physician
29924IAMDGeriatric Medicine (Family Medicine) Physician

Interoperability endpoints

  • Direct secure messaging: fkobylarz18057@epicdirect.rwjbh.org

Organizations & group practices 1

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713830400000",
    "number": "1023110749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 W GILBERT ST",
            "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": "18 CENTRE DR",
            "city": "MONROE TOWNSHIP",
            "state": "NJ",
            "postal_code": "088311501",
            "telephone_number": "609-655-5178",
            "fax_number": "609-655-5284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOBYLARZ",
        "first_name": "FRED",
        "middle_name": "A",
        "credential": "MD, MPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-02",
        "last_updated": "2024-04-23",
        "certification_date": "2024-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA0628900",
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "IA",
            "license": "29924",
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "FL",
            "license": "ME90906",
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "NJ",
            "license": "25MA0628900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6933904",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe Township, NJ

Sources for this page

Verify at the official NPI Registry.