Carl Joseph Renner, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

25MA03936900 Issued in NJ

Practice address

288 Boulevard Ste 2
Hasbrouck Heights, NJ 07604-1319

Phone

(201) 288-6781

Fax

(201) 288-2734

NPI assigned

Apr 19, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557792000000",
    "number": "1346205705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "288 BOULEVARD STE 2",
            "city": "HASBROUCK HEIGHTS",
            "state": "NJ",
            "postal_code": "076041319",
            "telephone_number": "201-288-6781",
            "fax_number": "201-288-2734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "288 BOULEVARD STE 2",
            "city": "HASBROUCK HEIGHTS",
            "state": "NJ",
            "postal_code": "076041319",
            "telephone_number": "201-288-6781",
            "fax_number": "201-288-2734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENNER",
        "first_name": "CARL",
        "middle_name": "JOSEPH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-19",
        "last_updated": "2019-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA03936900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1570501",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alissa Pirak
• Ryan Pomarico
• David F Porter, D.O.
• Irina Profis
• Red Bridge Consulting LLC
• Roger J Szanto DMD
• Richard William Rondanina, M.D
• Jeffrey Scott Rucker, PHARM. D.
• James Salazar, DPM
• Jesmerlyn Sanchez de Ramirez, MASSAGES THERAPIST

• Internal Medicine Physician in Hasbrouck Heights, NJ
• Providers in Hasbrouck Heights, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.