Individual provider Active NPI

Russell R Hoffman

  • Obstetrics & Gynecology Physician
  • Mountainside, NJ
National Provider Identifier
1356476063
Registry record updated Mar 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
MA59282 Issued in NJ
Practice address
200 Sheffield St Ste 313
Mountainside, NJ 07092-2321
Phone
(908) 273-3335
Fax
(908) 273-4648
NPI assigned
Feb 22, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X MA59282 NJ Primary

Addresses

Primary practice location

200 Sheffield St Ste 313
Mountainside, NJ 07092-2321

Mailing address

576 Springfield Ave
Summit, NJ 07901-4502
Phone (908) 273-3335

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
I20120509000564 NJ Practitioner - Obstetrics/Gynecology 4284896184 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

576 Springfield Ave
Apt 1
Summit, NJ 07901-4508
Phone 9082733335514

Hospital & facility affiliations

  • Overlook Medical Center Hospital, Summit, NJ, CCN 310051

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA59282NJMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Russell R. Hoffman,M.D.,P.a. Obstetrics & Gynecology CurrentSince Mar 5, 2012 Accepting new patients

Locations

200 Sheffield St
Ste 313
Mountainside, NJ 07092
Phone (732) 947-2631

Interoperability endpoints

  • Direct secure messaging: russell.hoffman@russellrhoffmanmdpa.ehi.direct-ci.com

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.

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": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615420800000",
    "number": "1356476063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "576 SPRINGFIELD AVE",
            "city": "SUMMIT",
            "state": "NJ",
            "postal_code": "079014502",
            "telephone_number": "908-273-3335",
            "fax_number": "908-273-4648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 SHEFFIELD ST STE 313",
            "city": "MOUNTAINSIDE",
            "state": "NJ",
            "postal_code": "070922321",
            "telephone_number": "908-273-3335",
            "fax_number": "908-273-4648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOFFMAN",
        "first_name": "RUSSELL",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-22",
        "last_updated": "2021-03-11",
        "certification_date": "2021-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NJ",
            "license": "MA59282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountainside, NJ

Sources for this page

Verify at the official NPI Registry.