Individual provider Active NPI

Mary E Kobran, RD

  • Registered Dietitian
  • Hackettstown, NJ
National Provider Identifier
1437761855
Registry record updated Dec 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Practice address
254B Mountain Ave Ste 100
Hackettstown, NJ 07840-2413
Phone
(908) 852-6400
Fax
(908) 852-6450
NPI assigned
Aug 18, 2020
Last updated
Dec 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X NU Primary

Addresses

Primary practice location

254B Mountain Ave Ste 100
Hackettstown, NJ 07840-2413

Mailing address

PO Box 95000 LB#7550
Philadelphia, PA 19195-7550
Phone (844) 362-1735

Other practice location 1

17 State Rt 23 N
Hamburg, NJ 07419-1419
Phone (973) 827-7800

Other practice location 2

8925 Lantana Meadow Dr
Fort Worth, TX 76131-1933
Phone (908) 674-3042

Other practice location 3

500 Greenwich St
Belvidere, NJ 07823-1409
Phone (908) 475-9990

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210415000228 NJ Practitioner - Registered Dietitian Or Nutrition Professional 1052729811 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Primary Care Partners LLCGroup PAC ID 2860665809, 74 clinicians

Practice addresses (Care Compare)

254 B Mountain Ave
Suite 304
Hackettstown, NJ 07840-2413
Phone (908) 852-6400

475 S St
Morristown, NJ 07960-6459
Phone (973) 971-5000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Care Partners, LLC Dietitian, Registered Current Accepting new patients
Primary Care Partners, LLC CurrentSince Mar 1, 2021 Accepting new patients
Good Seeds Nutrition LLC Dietitian, Registered CurrentSince Dec 15, 2024 Accepting new patients
Primary Care Partners, LLC PastSince Aug 1, 2020 Accepting new patients
Nourish, Inc. Dietitian, Registered Past Accepting new patients

Locations

500 Greenwich St
Belvidere, NJ 07823
Phone (908) 475-8750

17 State Rt 23 N
Hamburg, NJ 07419
Phone (973) 827-7800

465 South St
Ste 200
Morristown, NJ 07960
Phone (973) 971-7130

475 South St
Morristown, NJ 07960
Phone (973) 660-3166

Organizations & group practices 5

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": "1597708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733702400000",
    "number": "1437761855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 95000 LB#7550",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191957550",
            "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": "254B MOUNTAIN AVE STE 100",
            "city": "HACKETTSTOWN",
            "state": "NJ",
            "postal_code": "078402413",
            "telephone_number": "908-852-6400",
            "fax_number": "908-852-6450"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17 State Rt 23 N",
            "address_purpose": "LOCATION",
            "city": "Hamburg",
            "state": "NJ",
            "postal_code": "074191419",
            "country_code": "US",
            "telephone_number": "973-827-7800",
            "fax_number": "973-809-7855",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8925 Lantana Meadow Dr",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761311933",
            "country_code": "US",
            "telephone_number": "908-674-3042",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "500 Greenwich St",
            "address_purpose": "LOCATION",
            "city": "Belvidere",
            "state": "NJ",
            "postal_code": "078231409",
            "country_code": "US",
            "telephone_number": "908-475-9990",
            "fax_number": "908-475-9993",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOBRAN",
        "first_name": "MARY",
        "middle_name": "E",
        "name_prefix": "Mrs.",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-18",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackettstown, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.