Individual provider Active NPI

Robert L Montalbano, MD

  • Emergency Medicine Physician
  • Bayonne, NJ
National Provider Identifier
1407879976
Registry record updated Jun 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MA55159 Issued in NJ
Practice address
29 E 29TH St
Bayonne, NJ 07002-4654
Phone
(856) 616-8100
NPI assigned
Jul 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MA55159 NJ Primary

Addresses

Primary practice location

29 E 29TH St
Bayonne, NJ 07002-4654

Mailing address

PO Box 5075
Cherry Hill, NJ 08034-5075

Other identifiers 3

IdentifierTypeStateIssuer
6918603MedicaidNJ
20197OtherNJUHP NON PAR #
P00477765OtherNJRR MCR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA55159NJMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ijkg Opco LLC Current Accepting new patients
Kenneth Faistl, MD,PA Past Accepting new patients

Locations

29 E 29th St
Bayonne, NJ 07002
Phone (201) 585-5000

Interoperability endpoints

  • Direct secure messaging: robert.montalbano@direct.bayonnemedicalcenter.md

Organizations & group practices 2

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": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244505600000",
    "number": "1407879976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5075",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080345075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 E 29TH ST",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070024654",
            "telephone_number": "856-616-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTALBANO",
        "first_name": "ROBERT",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2009-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "MA55159",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6918603",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHP NON PAR #",
            "identifier": "20197",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MCR",
            "identifier": "P00477765",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayonne, NJ

Sources for this page

Verify at the official NPI Registry.