Dmitriy Podlog

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

25MB12408400 Issued in NJ

Practice address

750 Brunswick Ave
Trenton, NJ 08638-4143

Phone

(609) 394-6031

NPI assigned

May 10, 2021

Last updated

Oct 19, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Emergency Medicine

Education

Lake Erie College of Osteopathic Medicine, Erie, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Emergency Physician Associates of North Jersey P CGroup PAC ID 7911992326, 125 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bayshore Medical Center Hospital, Holmdel, NJ, CCN 310112

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Emergency Physician Associates of North Jersey P C

  • Emergency Medicine Physician
  • Summit, NJ
  • NPI 1497783419
  Medicare reassignment Care Compare group NPD

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

• HMH Hospitals Corporation

  dba Hackensack Meridian Diagnostic Laboratory

  • Clinical Medical Laboratory
  • Holmdel, NJ
  • NPI 1740907336

  Hospital

  Care Compare affiliation
• HMH Hospitals Corporation

  dba Bayshore Community Hospital

  • General Acute Care Hospital
  • Holmdel, NJ
  • NPI 1760994412
  Care Compare affiliation

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

{
    "created_epoch": "1620604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729296000000",
    "number": "1023692704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 BRUNSWICK AVE",
            "city": "TRENTON",
            "state": "NJ",
            "postal_code": "086384143",
            "telephone_number": "609-394-6031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 BRUNSWICK AVE",
            "city": "TRENTON",
            "state": "NJ",
            "postal_code": "086384143",
            "telephone_number": "609-394-6031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PODLOG",
        "first_name": "DMITRIY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-10",
        "last_updated": "2024-10-19",
        "certification_date": "2024-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "25MB12408400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natalia Plotskaya, M.D.
• Poblete Associates, P.a.
• Estrella M Poblete, MD
• Fredrick Poblete, M.D.
• Honesto Nazareno Poblete, M.D.
• Anastasiia Polianovskaia, MD
• Nicholas F Polk, PROFESSIONAL CLINICA
• Anthony Polombo Jr., DO
• Rebecca Popiolek, APRN, CNM
• Ivan David Popkin, DDS

• Emergency Medicine Physician in Trenton, NJ
• Providers in Trenton, NJ by specialty
• Emergency Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.