Individual provider Active NPI

Robert A. Blozen Jr., D.C.

  • Chiropractor
  • Holmdel, NJ
National Provider Identifier
1043384233
Registry record updated Sep 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38MC00308000 Issued in NJ
Practice address
2124 State Route 35
Holmdel, NJ 07733-1084
Phone
(732) 671-7277
Fax
(732) 671-5952
NPI assigned
Nov 20, 2006
Last updated
Sep 29, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 38MC00308000 NJ Primary

Addresses

Primary practice location

2124 State Route 35
Holmdel, NJ 07733-1084

Mailing address

2124 State Route 35
Holmdel, NJ 07733-1084
Phone (732) 671-7277

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090403000414 NJ Practitioner - Chiropractic 2961559166 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New Jersey Sports Chiropractic and Physical TherapyGroup PAC ID 7810473758, 5 clinicians

Practice addresses (Care Compare)

2124 State Route 35
Holmdel, NJ 07733-1084
Phone (732) 671-7277

436 State Route 79
Suite 21
Morganville, NJ 07751-9797
Phone (432) 617-8000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
38MC00308000NJMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Blozen Chiropractic PC Chiropractor CurrentSince Jan 20, 2009 Accepting new patients

Locations

2124 State Route 35
Holmdel, NJ 07733
Phone (732) 671-7277

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222646400000",
    "number": "1043384233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2124 STATE ROUTE 35",
            "city": "HOLMDEL",
            "state": "NJ",
            "postal_code": "077331084",
            "telephone_number": "732-671-7277",
            "fax_number": "732-671-5952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2124 STATE ROUTE 35",
            "city": "HOLMDEL",
            "state": "NJ",
            "postal_code": "077331084",
            "telephone_number": "732-671-7277",
            "fax_number": "732-671-5952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOZEN",
        "first_name": "ROBERT",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2008-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00308000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holmdel, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.