NPIMap

Individual provider Active NPI

Marc D Gellman, M.D.

  • Anesthesiology Physician
  • Gibbsboro, NJ
National Provider Identifier
1366495194
Registry record updated Dec 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
MD026023E Issued in PA
Practice address
82 Blue Herron Way
Gibbsboro, NJ 08026-1508
Phone
(856) 435-4233
Fax
(856) 435-4233
NPI assigned
May 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X MD026023E PA Primary
Anesthesiology Physician 207L00000X 25MA04206600 NJ

Addresses

Primary practice location

82 Blue Herron Way
Gibbsboro, NJ 08026-1508

Mailing address

82 Blue Heron Way
Gibbsboro, NJ 08026-1508
Phone (856) 435-4233

Other identifiers 1

IdentifierTypeStateIssuer
0009367460002MedicaidPA

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

State licenses

LicenseStateTypeSpecialty
25MA04206600NJMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Penn Valley Anesthesia Associates, LLC Anesthesiology Past Accepting new patients
Marlton Anesthesia & Pain Treatment LLC Anesthesiology Past Accepting new patients
Gloucester County Pain Associates PC Anesthesiology Past Accepting new patients
Professional Anesthesia Consultants, PC Anesthesiology Past Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197417600000",
    "number": "1366495194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82 BLUE HERON WAY",
            "city": "GIBBSBORO",
            "state": "NJ",
            "postal_code": "080261508",
            "telephone_number": "856-435-4233",
            "fax_number": "856-435-4233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82 BLUE HERRON WAY",
            "city": "GIBBSBORO",
            "state": "NJ",
            "postal_code": "080261508",
            "telephone_number": "856-435-4233",
            "fax_number": "856-435-4233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GELLMAN",
        "first_name": "MARC",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2007-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "PA",
            "license": "MD026023E",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NJ",
            "license": "25MA04206600",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0009367460002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gibbsboro, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 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.

Verify at the official NPI Registry.