Active NPI
David Pepose, PA
- Physician Assistant
- East Brunswick, NJ
National Provider Identifier
1215403969
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 25MP00499700
- Practice address
- D4 Brier Hill CT
East Brunswick, NJ 08816-3335 - Phone
- (848) 373-6610
- Fax
- (848) 290-8204
- NPI assigned
- Oct 21, 2018
- Last updated
- Sep 25, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 25MP00499700 | NJ | Primary |
Addresses
Primary practice location
D4 Brier Hill CT
East Brunswick, NJ 08816-3335
Mailing address
D4 Brier Hill CT
East Brunswick, NJ 08816-3335
Other names 1
- David Pepose
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MP00499700 | NJ | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Blu Medical LLC | Current | Accepting new patients |
Organizations & group practices 1
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": "1540080000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727222400000",
"number": "1215403969",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "D4 BRIER HILL CT",
"city": "EAST BRUNSWICK",
"state": "NJ",
"postal_code": "088163335"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "D4 BRIER HILL CT",
"city": "EAST BRUNSWICK",
"state": "NJ",
"postal_code": "088163335",
"telephone_number": "848-373-6610",
"fax_number": "848-290-8204"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEPOSE",
"first_name": "DAVID",
"credential": "PA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-10-21",
"last_updated": "2024-09-25",
"certification_date": "2024-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NJ",
"license": "25MP00499700",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "DAVID",
"last_name": "PEPOSE",
"credential": "PA",
"code": "2",
"type": "Professional Name"
}
]
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.