Individual provider Active NPI

Robert Lawrence Werner, DO

  • Internal Medicine Physician
  • Long Valley, NJ
National Provider Identifier
1174558225
Registry record updated Feb 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MB41143 Issued in NJ
Practice address
16 Schooleys Mountain Rd
Long Valley, NJ 07853-6223
Phone
(908) 777-1379
Fax
(803) 205-2432
NPI assigned
Jul 11, 2006
Sex
Male
Sole proprietor
Yes

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MB41143 NJ Primary

Addresses

Primary practice location

16 Schooleys Mountain Rd
Long Valley, NJ 07853-6223

Mailing address

16 Schooleys Mountain Rd
Long Valley, NJ 07853-6223
Phone (908) 777-1379

Other identifiers 3

IdentifierTypeStateIssuer
222598231OtherRR MEDICARE
222598231OtherFEDERAL BCBS
222598231OtherBCBS OF NJ&NY

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
I20051020000026 NJ Practitioner - Internal Medicine 0749206605 Practice locations: Long Valley, NJ

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MB41143NJMDInternal Medicine Physician

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": "1174558225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 SCHOOLEYS MOUNTAIN RD",
            "city": "LONG VALLEY",
            "state": "NJ",
            "postal_code": "078536223",
            "telephone_number": "908-777-1379",
            "fax_number": "803-205-2432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 SCHOOLEYS MOUNTAIN RD",
            "city": "LONG VALLEY",
            "state": "NJ",
            "postal_code": "078536223",
            "telephone_number": "908-777-1379",
            "fax_number": "803-205-2432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WERNER",
        "first_name": "ROBERT",
        "middle_name": "LAWRENCE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2022-02-02",
        "certification_date": "2022-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "MB41143",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "222598231",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL BCBS",
            "identifier": "222598231",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NJ&NY",
            "identifier": "222598231",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Valley, NJ

Sources for this page

Verify at the official NPI Registry.