Individual provider Active NPI

Robert L Taylor, M.D.

  • Family Medicine Physician
  • Millburn, NJ
National Provider Identifier
1063464808
Registry record updated Oct 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MA01729300 Issued in NJ
Practice address
25 East Willow St.
Millburn, NJ 07041
Phone
(973) 467-5607
Fax
(973) 376-4872
NPI assigned
May 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MA017293 NJ
Family Medicine Physician 207Q00000X 25MA01729300 NJ Primary

Addresses

Primary practice location

25 East Willow St.
Millburn, NJ 07041

Mailing address

25 East Willow St.
Millburn, NJ 07041
Phone (973) 467-5607

Other identifiers 1

IdentifierTypeStateIssuer
0316407MedicaidNJ

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
I20050511000811 NJ Practitioner - Family PracticePractitioner - Internal Medicine 0042250755 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA01729300NJMDFamily Medicine Physician
MA017293NJMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Robert L Taylor MD Medical Associates LLP Family Medicine CurrentSince Sep 1, 2006 Accepting new patients

Locations

25 E Willow St
Millburn, NJ 07041
Phone (973) 379-5055

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571788800000",
    "number": "1063464808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 EAST WILLOW ST.",
            "city": "MILLBURN",
            "state": "NJ",
            "postal_code": "07041",
            "telephone_number": "973-467-5607",
            "fax_number": "973-376-4872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 EAST WILLOW ST.",
            "city": "MILLBURN",
            "state": "NJ",
            "postal_code": "07041",
            "telephone_number": "973-467-5607",
            "fax_number": "973-376-4872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "ROBERT",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2019-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "MA017293",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA01729300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0316407",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Millburn, NJ

Sources for this page

Verify at the official NPI Registry.