Individual provider Active NPI

Ludmila Maria Engelbach, MD

  • Specialist
  • Manahawkin, NJ
National Provider Identifier
1336174945
Registry record updated Sep 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Practice address
1140 Route 72 West
Manahawkin, NJ 08050-2412
Phone
(609) 978-8900
Fax
(609) 978-3176
NPI assigned
Jul 12, 2006
Last updated
Sep 20, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X 36604 NJ
Specialist 174400000X NU Primary

Addresses

Primary practice location

1140 Route 72 West
Manahawkin, NJ 08050-2412

Mailing address

PO Box 19
1 Robert Wood Johnson Place, Meb 212
New Brunswick, NJ 08901-1928
Phone (732) 235-8120

Other identifiers 2

IdentifierTypeStateIssuer
2067307MedicaidNJ
P00953436OtherNJR R MCR

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
I20080520000304 NJ Practitioner - Pathology 1557430337 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Meridian Laboratory Physicians, PAGroup PAC ID 5193707032, 20 clinicians

Practice addresses (Care Compare)

1 Riverview PLZ
Red Bank, NJ 07701-1864
Phone (732) 741-2700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36604NJMDContractor

Practice roles

OrganizationSpecialtyStatusNew patients
Meridian Laboratory Physicians PA CurrentSince Jan 1, 2017 Accepting new patients

Locations

727 N Beers St
Holmdel, NJ 07733
Phone (732) 714-2700

1 Riverview Plz
Red Bank, NJ 07701
Phone (732) 530-2204

1140 Route 72 W
Stafford Township, NJ 08050
Phone (609) 978-2194

1945 State Route 33
Wall Township, NJ 07753
Phone (732) 776-2333

425 Jack Martin Blvd
Wall Township, NJ 08724
Phone (732) 840-2200

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316476800000",
    "number": "1336174945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19",
            "address_2": "1 ROBERT WOOD JOHNSON PLACE, MEB 212",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089011928",
            "telephone_number": "732-235-8120",
            "fax_number": "732-235-4661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 ROUTE 72 WEST",
            "city": "MANAHAWKIN",
            "state": "NJ",
            "postal_code": "080502412",
            "telephone_number": "609-978-8900",
            "fax_number": "609-978-3176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENGELBACH",
        "first_name": "LUDMILA",
        "middle_name": "MARIA",
        "name_prefix": "Ms.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2011-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "NJ",
            "license": "36604",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2067307",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "R R MCR",
            "identifier": "P00953436",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manahawkin, NJ

Sources for this page

Verify at the official NPI Registry.