Individual provider Active NPI

Mitchell Jablons, MD

  • Anesthesiology Physician
  • Summit, NJ
National Provider Identifier
1164483418
Registry record updated Feb 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
25MA04398100 Issued in NJ
Practice address
33 Overlook Rd
Ste 311
Summit, NJ 07901-3570
Phone
(908) 598-1500
NPI assigned
Mar 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 25MA04398100 NJ Primary

Addresses

Primary practice location

33 Overlook Rd
Ste 311
Summit, NJ 07901-3570

Mailing address

PO Box 48078
Newark, NJ 07101-4878

Other practice location 1

1 Diamond Hill Rd
Berkeley Heights, NJ 07922-2104
Phone (908) 273-4300

Other identifiers 1

IdentifierTypeStateIssuer
0381209MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050401000119 NJ Practitioner - Anesthesiology 6305740838 Reassigns benefits to 1 organization
I20200803001576 NY Practitioner - Anesthesiology 6305740838 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ny NJ Anesthesia LLC Anesthesiology CurrentSince Sep 4, 2018 Accepting new patients
North Shore - Lij Anesthesiology, PC Anesthesiology CurrentSince Jan 23, 2020 Accepting new patients
Summit Anesthesia Associates PA Anesthesiology Past Accepting new patients
Trinitas Anesthesia Associates, LLC Anesthesiology Past Accepting new patients

Locations

1 W Ridgewood Ave
Paramus, NJ 07652
Phone (201) 444-3060

2401 E Evesham Rd
Ste F
Voorhees, NJ 08043
Phone (856) 673-1600

195 E Main St
Huntington, NY 11743
Phone (631) 385-8677

475 Seaview Ave
Staten Island, NY 10305
Phone (718) 226-8855

Organizations & group practices 4

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": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612396800000",
    "number": "1164483418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 48078",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071014878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 OVERLOOK RD",
            "address_2": "STE 311",
            "city": "SUMMIT",
            "state": "NJ",
            "postal_code": "079013570",
            "telephone_number": "908-598-1500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Diamond Hill Rd",
            "address_purpose": "LOCATION",
            "city": "Berkeley Heights",
            "state": "NJ",
            "postal_code": "079222104",
            "country_code": "US",
            "telephone_number": "908-273-4300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JABLONS",
        "first_name": "MITCHELL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-28",
        "last_updated": "2021-02-04",
        "certification_date": "2021-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NJ",
            "license": "25MA04398100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0381209",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Summit, NJ

Sources for this page

Verify at the official NPI Registry.