Individual provider Active NPI

Robin G Midouhas, APN

  • Nurse Practitioner
  • Manahawkin, NJ
National Provider Identifier
1235164823
Registry record updated Feb 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
26NC05720000 Issued in NJ
Practice address
712 East Bay Avenue
Suite 21-C
Manahawkin, NJ 08050
Phone
(609) 597-5327
Fax
(609) 756-4452
NPI assigned
Jul 11, 2006
Last updated
Feb 10, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Clinical Nurse Specialist 364SP0808X 26NC05720000 NJ
Nurse Practitioner 363L00000X 26NC05720000 NJ Primary

Addresses

Primary practice location

712 East Bay Avenue
Suite 21-C
Manahawkin, NJ 08050

Mailing address

712 East Bay Avenue
Suite 21-C
Manahawkin, NJ 08050
Phone (609) 597-5327

Other identifiers 1

IdentifierTypeStateIssuer
7210604MedicaidNJ

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050811000014 NJ Practitioner - Certified Clinical Nurse Specialist (CNS) 0042249930 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Clinical Nurse Specialist (CNS)
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ocean Mental Health Services IncGroup PAC ID 7416943709, 35 clinicians

Practice addresses (Care Compare)

160 Route 9
Bayville, NJ 08721-1229
Phone 7323491977128

40 Bey Lea Rd
BLDG a
Toms River, NJ 08753-2989
Phone 7323495550128

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NC05720000NJMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Central Jersey Behavioral Health Associates Inc Past Accepting new patients

Organizations & group practices 2

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": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581292800000",
    "number": "1235164823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "712 EAST BAY AVENUE",
            "address_2": "SUITE 21-C",
            "city": "MANAHAWKIN",
            "state": "NJ",
            "postal_code": "08050",
            "telephone_number": "609-597-5327",
            "fax_number": "609-756-4452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "712 EAST BAY AVENUE",
            "address_2": "SUITE 21-C",
            "city": "MANAHAWKIN",
            "state": "NJ",
            "postal_code": "08050",
            "telephone_number": "609-597-5327",
            "fax_number": "609-756-4452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIDOUHAS",
        "first_name": "ROBIN",
        "middle_name": "G",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2020-02-10",
        "certification_date": "2020-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NC05720000",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NC05720000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7210604",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manahawkin, NJ

Sources for this page

Verify at the official NPI Registry.