Active NPI
Robert F. Conkling, M.D.
- Adult Medicine Physician
- Manasquan, NJ
National Provider Identifier
1174725477
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Medicine Physician
- License
- 25MA05135400
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101058846 | VA | MD | Family Medicine Physician |
| 25MA05135400 | NJ | MD | General Practice Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sudley Medical Clinic Inc | Family Medicine | Current | Accepting new patients |
| Frederick Health Hospital Inc | Past | Accepting new patients | |
| Medidoctors Primary Care LLC | Family Medicine | Past | Accepting new patients |
| Summit Medical Group PA | Past | Accepting new patients |
Locations
10757 Ambassador Dr
Ste 101
Manassas, VA 20109
Phone (571) 379-7395
Interoperability endpoints
- 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.
-
- Multi-Specialty Clinic/Center
- Berkeley Heights, NJ
- NPI 1942254347
-
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
-
- Infectious Disease Physician
- Fredericksburg, VA
- NPI 1063467975
Family Medicine
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.