Individual provider Active NPI

Seymour Schlossberg, DO

  • Family Medicine Physician
  • Wayne, NJ
National Provider Identifier
1043247786
Registry record updated Nov 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MB01934200 Issued in NJ
Practice address
2 Mayfair Dr
Wayne, NJ 07470-3703
Phone
(973) 696-1555
Fax
(973) 696-5677
NPI assigned
Jun 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25MB01934200 NJ Primary

Addresses

Primary practice location

2 Mayfair Dr
Wayne, NJ 07470-3703

Mailing address

2 Mayfair Dr
Wayne, NJ 07470-3703
Phone (973) 696-1555

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
I20111130000294 NJ Practitioner - General Practice 3577737667 Practice locations: Wayne, NJ

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636070400000",
    "number": "1043247786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 MAYFAIR DR",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074703703",
            "telephone_number": "973-696-1555",
            "fax_number": "973-696-5677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 MAYFAIR DR",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074703703",
            "telephone_number": "973-696-1555",
            "fax_number": "973-696-5677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHLOSSBERG",
        "first_name": "SEYMOUR",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2021-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MB01934200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayne, NJ

Sources for this page

Verify at the official NPI Registry.