Active NPI
Martin Riss, DO
- Family Medicine Physician
- Brick, NJ
National Provider Identifier
1548276827
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 27464
- Practice address
- 34 Lanes Mill Rd
Brick, NJ 08724 - Phone
- (732) 458-0300
- Fax
- (732) 458-8449
- NPI assigned
- Jul 31, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 27464 | NJ | Primary |
Addresses
Primary practice location
34 Lanes Mill Rd
Brick, NJ 08724
Mailing address
34 Lanes Mill Rd
Brick, NJ 08724
Phone (732) 458-0300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0538001 | Medicaid | NJ |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 1972
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
34 Lanes Mill Rd
Brick, NJ 08724-7056
Phone (732) 458-0300
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27464 | NJ | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bricktown Medical Group PA | Family Medicine | Current | Accepting new patients |
Locations
34 Lanes Mill Rd
Unit 2
Brick, NJ 08724
34 Lanes Mill Rd
Brick, NJ 08724
Phone (732) 202-0911
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1548276827",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "34 LANES MILL RD",
"city": "BRICK",
"state": "NJ",
"postal_code": "08724",
"telephone_number": "732-458-0300",
"fax_number": "732-458-8449"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "34 LANES MILL RD",
"city": "BRICK",
"state": "NJ",
"postal_code": "08724",
"telephone_number": "732-458-0300",
"fax_number": "732-458-8449"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RISS",
"first_name": "MARTIN",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NJ",
"license": "27464",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0538001",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Brick, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.