Individual provider Active NPI

Robert F. Conkling, M.D.

  • Adult Medicine Physician
  • Manasquan, NJ
National Provider Identifier
1174725477
Registry record updated Sep 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
25MA05135400 Issued in NJ
Practice address
2401 Algonkin Trail
Manasquan, NJ 08736
Phone
(202) 320-8834
Fax
(434) 385-8616
NPI assigned
May 31, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2018

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101058846 VA
Geriatric Medicine (Family Medicine) Physician 207QG0300X 25MA05135400 NJ
General Practice Physician 208D00000X 25MA05135400 NJ
Adult Medicine Physician 207QA0505X 25MA05135400 NJ Primary

Addresses

Primary practice location

2401 Algonkin Trail
Manasquan, NJ 08736

Mailing address

P.O. Box 604
Manasquan, NJ 08736
Phone (202) 320-8834

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101058846VAMDFamily Medicine Physician
25MA05135400NJMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sudley Medical Clinic Inc Family Medicine CurrentSince Jun 1, 2012 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Medidoctors Primary Care LLC Family Medicine PastSince Apr 18, 2011 Accepting new patients
Summit Medical Group PA PastSince Jul 4, 2018 Accepting new patients

Locations

10757 Ambassador Dr
Ste 101
Manassas, VA 20109
Phone (571) 379-7395

Interoperability endpoints

  • Direct secure messaging: hackensackmeridian.robertconkling@136290.advancedmd-direct.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1180569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537920000000",
    "number": "1174725477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 604",
            "city": "MANASQUAN",
            "state": "NJ",
            "postal_code": "08736",
            "telephone_number": "202-320-8834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 ALGONKIN TRAIL",
            "city": "MANASQUAN",
            "state": "NJ",
            "postal_code": "08736",
            "telephone_number": "202-320-8834",
            "fax_number": "434-385-8616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONKLING",
        "first_name": "ROBERT",
        "middle_name": "F.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-31",
        "last_updated": "2018-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101058846",
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "NJ",
            "license": "25MA05135400",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NJ",
            "license": "25MA05135400",
            "primary": false
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "NJ",
            "license": "25MA05135400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manasquan, NJ

Sources for this page

Verify at the official NPI Registry.