Individual provider Active NPI

Honesto Nazareno Poblete, M.D.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Trenton, NJ
National Provider Identifier
1427091552
Registry record updated Jul 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
28176 Issued in NJ
Practice address
1601 Whitehorse Mercerville Rd
Suite 2
Trenton, NJ 08619-3821
Phone
(609) 586-1313
Fax
(609) 584-9227
NPI assigned
Jun 14, 2006
Last updated
Jul 30, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 28176 NJ Primary

Addresses

Primary practice location

1601 Whitehorse Mercerville Rd
Suite 2
Trenton, NJ 08619-3821

Mailing address

1601 Whitehorse Mercerville Rd
Suite 2
Trenton, NJ 08619-3821
Phone (609) 586-1313

Other identifiers 1

IdentifierTypeStateIssuer
2806606MedicaidNJ

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
28176NJMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Poblete Dermatology LLC Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406678400000",
    "number": "1427091552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 WHITEHORSE MERCERVILLE RD",
            "address_2": "SUITE 2",
            "city": "TRENTON",
            "state": "NJ",
            "postal_code": "086193821",
            "telephone_number": "609-586-1313",
            "fax_number": "609-584-9227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 WHITEHORSE MERCERVILLE RD",
            "address_2": "SUITE 2",
            "city": "TRENTON",
            "state": "NJ",
            "postal_code": "086193821",
            "telephone_number": "609-586-1313",
            "fax_number": "609-584-9227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POBLETE",
        "first_name": "HONESTO",
        "middle_name": "NAZARENO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2014-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "NJ",
            "license": "28176",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2806606",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Trenton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2014; 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.