Individual provider Active NPI

Karl Kenneth Mercado Tobias

  • Acute Care Nurse Practitioner
  • Edison, NJ
National Provider Identifier
1144057712
Registry record updated Sep 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
433115 Issued in NY
Practice address
65 James St
Edison, NJ 08820-3947
Phone
(732) 744-5888
NPI assigned
Sep 18, 2024
Last updated
Sep 18, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 26NR17935600 NJ
Acute Care Nurse Practitioner 363LA2100X 433115 NY Primary

Addresses

Primary practice location

65 James St
Edison, NJ 08820-3947

Mailing address

912 Merritt Dr Apt E
Hillsborough, NJ 08844-5316

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241127001263 NJ Practitioner - Nurse Practitioner 7113452152 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospitalist Physicians of New Jersey PAGroup PAC ID 3476859927, 162 clinicians

Practice addresses (Care Compare)

65 James St
Edison, NJ 08820-3947
Phone (732) 321-7000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NR17935600NJMDAcute Care Nurse Practitioner
433115NYMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Great Health Medical New Jersey PC CurrentSince Dec 13, 2025 Accepting new patients
Hospitalist Physicians of New Jersey PA CurrentSince Jan 13, 2025 Accepting new patients

Locations

300 Central Ave
East Orange, NJ 07018
Phone (973) 266-8460

65 James St
Edison, NJ 08820
Phone (732) 321-7010

101 Chase Ave
Ste 105
Lakewood, NJ 08701
Phone (212) 201-1252

407 Willoughby Ave
Brooklyn, NY 11205
Phone (212) 201-1252

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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": "1726617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1144057712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "912 MERRITT DR APT E",
            "city": "HILLSBOROUGH",
            "state": "NJ",
            "postal_code": "088445316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 JAMES ST",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088203947",
            "telephone_number": "732-744-5888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOBIAS",
        "first_name": "KARL KENNETH",
        "middle_name": "MERCADO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-18",
        "last_updated": "2024-09-18",
        "certification_date": "2024-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NJ",
            "license": "26NR17935600",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NY",
            "license": "433115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edison, NJ

Sources for this page

Verify at the official NPI Registry.