Active NPI
Marc Bernard Appelbaum, D.D.S.
- Prosthodontics
- Albuquerque, NM
National Provider Identifier
1366447898
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- DD4635
- Practice address
- 1801 Camino de Salud NE
Albuquerque, NM 87102-4516 - Phone
- (505) 925-4031
- NPI assigned
- Jun 21, 2005
- Reactivated
- Mar 27, 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 |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | DD4635 | NM | Primary |
Addresses
Primary practice location
1801 Camino de Salud NE
Albuquerque, NM 87102-4516
Mailing address
1177 South Summit Drive
Santa Fe, NM 87501
Phone (908) 295-3401
Other practice location 1
41 Elm St
Morristown, NJ 07960-7201
Phone (973) 540-1311
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: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150826001050 | NJ | Order and Referring Only - Dentist | 7012223746 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DD4635 | NM | MD | Prosthodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1523923200000",
"number": "1366447898",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1177 SOUTH SUMMIT DRIVE",
"city": "SANTA FE",
"state": "NM",
"postal_code": "87501",
"telephone_number": "908-295-3401"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1801 CAMINO DE SALUD NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871024516",
"telephone_number": "505-925-4031"
}
],
"practiceLocations": [
{
"address_1": "41 Elm St",
"address_purpose": "LOCATION",
"city": "Morristown",
"state": "NJ",
"postal_code": "079607201",
"country_code": "US",
"telephone_number": "973-540-1311",
"fax_number": "973-540-0092",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "APPELBAUM",
"first_name": "MARC",
"middle_name": "BERNARD",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-06-21",
"last_updated": "2018-04-17",
"deactivation_date": "2006-03-21",
"reactivation_date": "2006-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "NM",
"license": "DD4635",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2018; 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.