Organization Active NPI

Poblete Associates, P.a.

  • Surgery Physician
  • Trenton, NJ
National Provider Identifier
1043247398
Registry record updated Jan 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
28176 Issued in NJ
Legal business name
POBLETE ASSOCIATES, P.A.
Practice address
1601 Whitehorse Mercerville Rd
Suite 1
Trenton, NJ 08619-3821
Phone
(609) 586-1313
Fax
(609) 584-9227
NPI assigned
Jun 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2015

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

Authorized official

Name
Dr. Fredrick Poblete, M.D.NPI 1508894247
Title
President
Phone
(609) 586-1313

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X 28176 NJ Primary

Addresses

Primary practice location

1601 Whitehorse Mercerville Rd
Suite 1
Trenton, NJ 08619-3821

Mailing address

1601 Whitehorse Mercerville Rd
Suite 1
Trenton, NJ 08619-3821
Phone (609) 586-1313

Other identifiers 1

IdentifierTypeStateIssuer
2806606MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061122000485 NJ Part B Supplier - Clinic/Group Practice 0244238434 Receives reassigned benefits from 1 practitioner
Practice locations: Mercerville, NJ; Trenton, NJ

National Provider Directory

National Provider Directory

Locations

1225 Whitehorse Mercerville Rd
Ste 209
Trenton, NJ 08619
Phone (609) 301-5788

1601 Whitehorse Mercerville Rd
Ste 1
Trenton, NJ 08619
Phone (609) 586-1313

1601 Whthrs Mrcvl Rd
Trenton, NJ 08619
Phone (609) 581-2583

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421884800000",
    "number": "1043247398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 WHITEHORSE MERCERVILLE RD",
            "address_2": "SUITE 1",
            "city": "TRENTON",
            "state": "NJ",
            "postal_code": "086193821",
            "telephone_number": "609-586-1313",
            "fax_number": "609-584-9227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 WHITEHORSE MERCERVILLE RD",
            "address_2": "SUITE 1",
            "city": "TRENTON",
            "state": "NJ",
            "postal_code": "086193821",
            "telephone_number": "609-586-1313",
            "fax_number": "609-584-9227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POBLETE ASSOCIATES, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-26",
        "last_updated": "2015-01-22",
        "status": "A",
        "authorized_official_last_name": "POBLETE",
        "authorized_official_first_name": "FREDRICK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "609-586-1313",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "NJ",
            "license": "28176",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2806606",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Trenton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2015; 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.