Individual provider Active NPI

Robert H Bennett, D.O.

  • Psychiatry Physician
  • Marlton, NJ
National Provider Identifier
1487716957
Registry record updated May 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MB053757 Issued in NJ
Practice address
214 Chestnut Ave
Marlton, NJ 08053-7148
Phone
(856) 220-7023
NPI assigned
Dec 14, 2006
Last updated
May 14, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MB053757 NJ Primary
Child & Adolescent Psychiatry Physician 2084P0804X MB053757 NJ

Addresses

Primary practice location

214 Chestnut Ave
Marlton, NJ 08053-7148

Mailing address

214 Chestnut Ave
Marlton, NJ 08053-7148
Phone (856) 220-7023

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100505000386 NJ Practitioner - Psychiatry 7810025293 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
MB053757NJMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Princeton Healthcare Affiliated Physicians PC Current Accepting new patients
Princeton Healthcare Affiliated Physicians PC CurrentSince Jan 31, 2010 Accepting new patients
Princeton House Provider Group LLC Psychiatry CurrentSince Sep 1, 2015 Accepting new patients
Princeton Healthcare Affiliated Physicians PC CurrentSince Jan 31, 2010 Accepting new patients
Princeton Healthcare System, a New Jersey Non-Profit Corporation Past Accepting new patients

Locations

401 Ridge Rd
Ste 6
Dayton, NJ 08810
Phone (732) 329-4800

993 Lenox Dr
Ste 207
Lawrenceville, NJ 08648

1460 Livingston Ave
Bldg 100
North Brunswick, NJ 08902
Phone (732) 729-3600

905 Herrontown Rd
Princeton, NJ 08540
Phone (609) 497-3300

1 Washington Blvd
Ste A
Trenton, NJ 08691
Phone (609) 448-4353

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": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715644800000",
    "number": "1487716957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 CHESTNUT AVE",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080537148",
            "telephone_number": "856-220-7023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 CHESTNUT AVE",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080537148",
            "telephone_number": "856-220-7023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "ROBERT",
        "middle_name": "H",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-14",
        "last_updated": "2024-05-14",
        "certification_date": "2024-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NJ",
            "license": "MB053757",
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NJ",
            "license": "MB053757",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marlton, NJ

Sources for this page

Verify at the official NPI Registry.