Individual provider Active NPI

Marc Klapholz, M.D.

  • Cardiovascular Disease Physician
  • Newark, NJ
National Provider Identifier
1063447829
Registry record updated Feb 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
25MA06249400 Issued in NJ
Practice address
90 Bergen St
Doc 3500
Newark, NJ 07103-2425
Phone
(973) 972-2573
Fax
(973) 972-4695
NPI assigned
Jul 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X 25MA06249400 NJ
Cardiovascular Disease Physician 207RC0000X 25MA06249400 NJ Primary

Addresses

Primary practice location

90 Bergen St
Doc 3500
Newark, NJ 07103-2425

Mailing address

30 Bergen St
Admc 12 1205
Newark, NJ 07107-3000

Other identifiers 1

IdentifierTypeStateIssuer
6610404MedicaidNJ

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mklapholz1575@direct.uhnj.org Direct University Hospital

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
I20111207000279 NJ Practitioner - Cardiovascular Disease (Cardiology) 6901887405 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Albert Einstein College of Medicine of Yeshiva University, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

90 Bergen St
Newark, NJ 07103-2425
Phone (973) 972-5004

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting1-10
Pacemaker insertion or repair1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA06249400NJMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Physician Associates of New Jersey Inc CurrentSince Sep 11, 1995 Accepting new patients
St Vincents Hospital and Medical Center Past Accepting new patients
University Physician Associates of New Jersey Inc Past Accepting new patients
Greenbaum, MD - Wagner, MD Past Accepting new patients
Rutgers Health-RWJ Primary Medicine Group PastSince Jul 1, 2017 Accepting new patients
Medical Service of St Vincent'S Hospital &Medical Center, P.C. Cardiovascular Disease Past Accepting new patients
University Hospital Past Accepting new patients

Locations

90 Bergen St
#3500
Newark, NJ 07103
Phone (973) 972-2573

150 Bergen St
Newark, NJ 07103
Phone (973) 972-6056

90 Bergen St
Newark, NJ 07103
Phone (973) 972-0037

30 Bergen St
#12
Newark, NJ 07107
Phone (973) 972-0037

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Rutgers Health - University Behavioral Health CarePiscataway, NJ, CCN 314011 Hospital Corporate Director Jul 1, 2017

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 7

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 1

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": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643760000000",
    "number": "1063447829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 BERGEN ST",
            "address_2": "ADMC 12 1205",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071073000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 BERGEN ST",
            "address_2": "DOC 3500",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032425",
            "telephone_number": "973-972-2573",
            "fax_number": "973-972-4695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLAPHOLZ",
        "first_name": "MARC",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2022-02-02",
        "certification_date": "2022-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NJ",
            "license": "25MA06249400",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NJ",
            "license": "25MA06249400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6610404",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mklapholz1575@direct.uhnj.org",
            "affiliation": "Y",
            "endpointDescription": "Epic",
            "affiliationName": "University Hospital",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "150 Bergen St",
            "city": "Newark",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "071032496",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.