Active NPI
Bruce M Klein, MD
- Pediatrics Physician
- Hammonton, NJ
National Provider Identifier
1275640302
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 25MA04053900
- Practice address
- 860 S White Horse Pike
Hammonton, NJ 08037-2018 - Phone
- (609) 567-0200
- Fax
- (609) 704-1482
- NPI assigned
- Aug 24, 2006
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 25MA04053900 | NJ | Primary |
Addresses
Primary practice location
860 S White Horse Pike
Hammonton, NJ 08037-2018
Mailing address
1 N White Horse Pike
Hammonton, NJ 08037-1875
Phone (609) 567-0200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0812501 | Medicaid | NJ |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA04053900 | NJ | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern Jersey Family Medical Centers, Inc | Current | Accepting new patients | |
| The Osborn Family Health Center, Inc. | Pediatrics | Past | Accepting new patients |
Locations
1 N White Horse Pike
Hammonton, NJ 08037
Phone (609) 567-0200
860 S White Horse Pike
Hammonton, NJ 08037
Phone (609) 567-0200
Interoperability endpoints
- https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.72983
- bklein@osbornfhc.directbygreenway.com
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.
-
- Federally Qualified Health Center (FQHC)
- Hammonton, NJ
- NPI 1568473973
NJ
-
- Family Medicine Physician
- Camden, NJ
- NPI 1528444254
Pediatrics
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156377600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1576022400000",
"number": "1275640302",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 N WHITE HORSE PIKE",
"city": "HAMMONTON",
"state": "NJ",
"postal_code": "080371875",
"telephone_number": "609-567-0200",
"fax_number": "609-704-1482"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "860 S WHITE HORSE PIKE",
"city": "HAMMONTON",
"state": "NJ",
"postal_code": "080372018",
"telephone_number": "609-567-0200",
"fax_number": "609-704-1482"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KLEIN",
"first_name": "BRUCE",
"middle_name": "M",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-24",
"last_updated": "2019-12-11",
"certification_date": "2019-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NJ",
"license": "25MA04053900",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0812501",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Hammonton, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2019; 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.