Individual provider Active NPI

Robert Milton Harris, M.D.

  • Internal Medicine Physician
  • Teaneck, NJ
National Provider Identifier
1225066533
Registry record updated Apr 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA03720000 Issued in NJ
Practice address
185 Cedar LN
Ste L1
Teaneck, NJ 07666-4303
Phone
(201) 928-1930
NPI assigned
Jun 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2017

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 25MA03720000 NJ Primary

Addresses

Primary practice location

185 Cedar LN
Ste L1
Teaneck, NJ 07666-4303

Mailing address

54 Montclair Ave
Nutley, NJ 07110-1124
Phone (973) 614-0277

Other identifiers 1

IdentifierTypeStateIssuer
0280801MedicaidNJ

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
I20110629000157 NJ Practitioner - Internal Medicine 6204014921 Reassigns benefits to 1 organization
Practice locations: Teaneck, NJ

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
New York University School of Medicine, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bergen County Improvement AuthorityGroup PAC ID 9032104047, 95 clinicians

Practice addresses (Care Compare)

230 E Ridgewood Ave
Paramus, NJ 07652-4142
Phone (201) 967-4000

Hospital & facility affiliations

  • Bergen New Bridge Medical Center Hospital, Paramus, NJ, CCN 310058

National Provider Directory

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

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491264000000",
    "number": "1225066533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 MONTCLAIR AVE",
            "city": "NUTLEY",
            "state": "NJ",
            "postal_code": "071101124",
            "telephone_number": "973-614-0277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 CEDAR LN",
            "address_2": "STE L1",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076664303",
            "telephone_number": "201-928-1930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "ROBERT",
        "middle_name": "MILTON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2017-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA03720000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0280801",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Teaneck, NJ

Sources for this page

Verify at the official NPI Registry.