NPIMap

Organization Active NPI

Trabecular Medical Group, LLC

  • Rheumatology Physician
  • Voorhees, NJ
National Provider Identifier
1427622661
Registry record updated May 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
Legal business name
TRABECULAR MEDICAL GROUP, LLC
Practice address
2301 E Evesham Rd Ste 115
Voorhees, NJ 08043-4509
Phone
(856) 424-5005
Fax
(856) 770-8271
NPI assigned
May 13, 2021
Last updated
May 13, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2021

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

Authorized official

Name
Charles F Haberkern
Title
Ceo
Phone
(856) 424-5005

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X Primary

Addresses

Primary practice location

2301 E Evesham Rd Ste 115
Voorhees, NJ 08043-4509

Mailing address

2301 E Evesham Rd Ste 115
Voorhees, NJ 08043-4509
Phone (856) 424-5005

Other identifiers 1

IdentifierTypeStateIssuer
2781603MedicaidNJ

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://www.carequality.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210610002078 NJ Part B Supplier - Clinic/Group Practice 2365842440 Receives reassigned benefits from 20 practitioners
Practice locations: Brick, NJ; Voorhees, NJ; Sewell, NJ; Moorestown, NJ; Hamilton, NJ; Galloway, NJ; Manasquan, NJ

National Provider Directory

National Provider Directory

Locations

1759 Highway 88
Brick, NJ 08724

314 Chris Gaupp Dr
Ste 103
Galloway, NJ 08205

3635 Quakerbridge Rd
Ste 33
Hamilton, NJ 08619

740 Marne Hwy
Ste 102
Moorestown, NJ 08057
Phone (856) 235-0001

354 Hurffville Crosskeys Rd
Sewell, NJ 08080
Phone (856) 557-5460

354 Hurffville Crosskeys Rd
Ste 100
Sewell, NJ 08080

2301 E Evesham Rd
Ste 115
Voorhees, NJ 08043
Phone (856) 770-9000

Practitioners & affiliated clinicians

Practitioners 22

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1620864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620864000000",
    "number": "1427622661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 E EVESHAM RD STE 115",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080434509",
            "telephone_number": "856-424-5005",
            "fax_number": "856-770-8271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 E EVESHAM RD STE 115",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080434509",
            "telephone_number": "856-424-5005",
            "fax_number": "856-770-8271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRABECULAR MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-13",
        "last_updated": "2021-05-13",
        "certification_date": "2021-05-12",
        "status": "A",
        "authorized_official_last_name": "HABERKERN",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "856-424-5005"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2781603",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://www.carequality.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "PIX FEED",
            "address_1": "354 Hurffville Crosskeys Rd Ste 100",
            "city": "Sewell",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080803553",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Voorhees, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.