Individual provider Active NPI

Reboy Cherian, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Long Branch, NJ
National Provider Identifier
1447536347
Registry record updated Oct 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00269700 Issued in NJ
Practice address
274 Bath Ave
Unit 11
Long Branch, NJ 07740-6176
Phone
(732) 222-5942
NPI assigned
Oct 24, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 25MP00269700 NJ Primary

Addresses

Primary practice location

274 Bath Ave
Unit 11
Long Branch, NJ 07740-6176

Mailing address

274 Bath Ave
Unit 11
Long Branch, NJ 07740-6176
Phone (732) 222-5942

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150924000042 NJ Practitioner - Physician Assistant 4789991811 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Barnabas Health Medical Group PCGroup PAC ID 9537316955, 1,027 clinicians

Practice addresses (Care Compare)

94 Old Short Hills Rd
Livingston, NJ 07039-5672

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
25MP00269700NJMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Barnabas Health Medical Group PC CurrentSince May 10, 2024 Accepting new patients
Barnabas Health Medical Group PC CurrentSince May 10, 2024 Accepting new patients

Locations

475 Route 70
Ste 101
Lakewood, NJ 08701
Phone (732) 364-8000

94 Old Short Hills Rd
Livingston, NJ 07039
Phone (973) 322-5400

Organizations & group practices 3

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": "1319414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319414400000",
    "number": "1447536347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "274 BATH AVE",
            "address_2": "UNIT 11",
            "city": "LONG BRANCH",
            "state": "NJ",
            "postal_code": "077406176",
            "telephone_number": "732-222-5942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "274 BATH AVE",
            "address_2": "UNIT 11",
            "city": "LONG BRANCH",
            "state": "NJ",
            "postal_code": "077406176",
            "telephone_number": "732-222-5942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHERIAN",
        "first_name": "REBOY",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-10-24",
        "last_updated": "2011-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00269700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Branch, NJ

Sources for this page

Verify at the official NPI Registry.