George Mbolu Jr., M.D

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

25MA11018000 Issued in NJ

Practice address

2 N Village Blvd Ste 2a
Sparta, NJ 07871-3592

Phone

(973) 579-3444

Fax

(908) 522-5121

NPI assigned

Mar 21, 2017

Last updated

Sep 29, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Pulmonary DiseaseAlso: Internal Medicine

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Practice Associates Medical GroupGroup PAC ID 5890703177, 1,412 clinicians

Route Intensivists Services LLCGroup PAC ID 6305189671, 10 clinicians

Intense Care LLCGroup PAC ID 2163860636, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Newton Medical Center Hospital, Newton, NJ, CCN 310028
• Ahs Hospital Corp Hospital, Hackettstown, NJ, CCN 310115
• Hackensack Meridian Mountainside Medical Hospital, Montclair, NJ, CCN 310054
• Morristown Medical Center Hospital, Morristown, NJ, CCN 310015

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gmbolu494528@direct.ahsys.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Intense Care LLC

  • Pulmonary Disease Physician
  • Roselle, NJ
  • NPI 1104684752
  Medicare reassignment Care Compare group NPD Authorized official
• Practice Associates Medical Group

  dba Atlantic Medical Group

  • Internal Medicine Physician
  • Morristown, NJ
  • NPI 1427016385
  Medicare reassignment Care Compare group NPD
• Route Intensivists Services LLC

  • Emergency Medicine Physician
  • Manahawkin, NJ
  • NPI 1447718531
  Medicare reassignment Care Compare group NPD
• Ccmma NJ LLC

  • Critical Care Medicine (Anesthesiology) Physician
  • Passaic, NJ
  • NPI 1124543095

  Pulmonary Disease

  Medicare reassignment NPD
• Mid Columbia Eyecare Center, Inc, PS

  • Optometrist
  • Pasco, WA
  • NPI 1750585972
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ahs Hospital Corp

  • General Acute Care Hospital
  • Hackettstown, NJ
  • NPI 1518969419
  Care Compare affiliation
• Ahs Hospital Corp

  dba Newton Medical Center

  • General Acute Care Hospital
  • Newton, NJ
  • NPI 1790789212
  Care Compare affiliation
• Ahs Hospital Corp.

  dba Morristown Medical Center

  • General Acute Care Hospital
  • Morristown, NJ
  • NPI 1053384776
  Care Compare affiliation
• Montclair Hospital LLC

  dba HackensackUMC Mountainside

  • General Acute Care Hospital
  • Montclair, NJ
  • NPI 1982720249
  Care Compare affiliation

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

{
    "created_epoch": "1490054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695945600000",
    "number": "1417488511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 416457",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022414837",
            "telephone_number": "844-362-1735",
            "fax_number": "973-290-7495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 N VILLAGE BLVD STE 2A",
            "city": "SPARTA",
            "state": "NJ",
            "postal_code": "078713592",
            "telephone_number": "973-579-3444",
            "fax_number": "908-522-5121"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "57 US Highway",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Hackettstown",
            "state": "NJ",
            "postal_code": "07840",
            "country_code": "US",
            "telephone_number": "908-522-5120",
            "fax_number": "908-522-5121",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Bay Ave",
            "address_purpose": "LOCATION",
            "city": "Montclair",
            "state": "NJ",
            "postal_code": "070424837",
            "country_code": "US",
            "telephone_number": "908-512-8191",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MBOLU",
        "first_name": "GEORGE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-21",
        "last_updated": "2023-09-29",
        "certification_date": "2023-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA11018000",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NJ",
            "license": "25MA11018000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gary J Mascilak, PT
• Tracy L Mascilak, PT
• Michael Mastaj
• Gillian Matos
• Charlene Armstrong Mayer, LPC
• Jarid Dior McCarthy
• Samantha R McCourt, MS, ED.
• Randi Jill McGivney, M.A. CCC-SLP
• Catherine Ann McHugh, MD
• Brittany McKay, BCBA

• Pulmonary Disease Physician in Sparta, NJ
• Providers in Sparta, NJ by specialty
• Pulmonary Disease Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.