Active NPI
Eric Gewolb, M.D.
- Psychiatry Physician
- Bayonne, NJ
National Provider Identifier
1326094871
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 25MA03446400
- Practice address
- 830 Kennedy Blvd
Bayonne, NJ 07002-2872 - Phone
- (201) 339-0200
- NPI assigned
- May 26, 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 25MA03446400 | NJ | Primary |
Addresses
Primary practice location
830 Kennedy Blvd
Bayonne, NJ 07002-2872
Mailing address
830 Kennedy Blvd
Bayonne, NJ 07002-2872
Phone (201) 339-0200
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4412155 | Other | NJ | PALMETTOGBA |
| 222264078 | Other | NJ | HORIZON BLUESHIELD |
| 2264078 | Other | NJ | OXFORD |
| 1014315 | Medicaid | NJ | |
| 222264078 | Other | NJ | QUALCARE |
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)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Scott & White Hospital - Taylor | Past | 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 and National Provider Directory roles.
-
- Emergency Medicine Physician
- Taylor, TX
- NPI 1659366557
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148601600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1326094871",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "830 KENNEDY BLVD",
"city": "BAYONNE",
"state": "NJ",
"postal_code": "070022872",
"telephone_number": "201-339-0200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "830 KENNEDY BLVD",
"city": "BAYONNE",
"state": "NJ",
"postal_code": "070022872",
"telephone_number": "201-339-0200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GEWOLB",
"first_name": "ERIC",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NJ",
"license": "25MA03446400",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PALMETTOGBA",
"identifier": "4412155",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HORIZON BLUESHIELD",
"identifier": "222264078",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD",
"identifier": "2264078",
"state": "NJ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1014315",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "QUALCARE",
"identifier": "222264078",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bayonne, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.