Individual provider Active NPI

Mary Melissa Tobiasson, D.O.

  • Internal Medicine Physician
  • Marlboro, NJ
National Provider Identifier
1265744072
Registry record updated Apr 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MB08783100 Issued in NJ
Practice address
32 N Main St
Marlboro, NJ 07746-1429
Phone
(732) 462-4100
Fax
(732) 462-4549
NPI assigned
Jul 9, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2012

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 25MB08783100 NJ Primary

Addresses

Primary practice location

32 N Main St
Marlboro, NJ 07746-1429

Mailing address

32 N Main St
Marlboro, NJ 07746-1429
Phone (732) 462-4100

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
I20110221000912 NJ Practitioner - Internal Medicine 5294916466 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Lake Erie College of Osteopathic Medicine, Erie, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Peters University HospitalGroup PAC ID 9931012382, 158 clinicians

Practice addresses (Care Compare)

123 How LN
New Brunswick, NJ 08901-3653
Phone (732) 745-8600

254 Easton Ave
New Brunswick, NJ 08901-1766
Phone (732) 745-8600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MB08783100NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Peter'S University Hospital CurrentSince Mar 11, 2014 Accepting new patients
Saint Peter'S University Hospital CurrentSince Mar 11, 2014 Accepting new patients

Locations

254 Easton Ave
Ofc
New Brunswick, NJ 08901
Phone (732) 745-6674

254 Easton Ave
New Brunswick, NJ 08901
Phone (732) 565-5453

123 How Ln
New Brunswick, NJ 08901
Phone (732) 448-1000

Interoperability endpoints

  • Direct secure messaging: mary.tobiasson.1@8568.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/8568/brand/1/csg/1/fhir/r4

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 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": "1278633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334707200000",
    "number": "1265744072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 N MAIN ST",
            "city": "MARLBORO",
            "state": "NJ",
            "postal_code": "077461429",
            "telephone_number": "732-462-4100",
            "fax_number": "732-462-4549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 N MAIN ST",
            "city": "MARLBORO",
            "state": "NJ",
            "postal_code": "077461429",
            "telephone_number": "732-462-4100",
            "fax_number": "732-462-4549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOBIASSON",
        "first_name": "MARY MELISSA",
        "name_prefix": "Mrs.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-09",
        "last_updated": "2012-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MB08783100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marlboro, NJ

Sources for this page

Verify at the official NPI Registry.