Individual provider Active NPI

Martin Riss, DO

  • Family Medicine Physician
  • Brick, NJ
National Provider Identifier
1548276827
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
27464 Issued in NJ
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

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
0538001MedicaidNJ

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
I20101218000011 NJ Practitioner - Family Practice 0840488714 Reassigns benefits to 1 organization

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

LicenseStateTypeSpecialty
27464NJMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bricktown Medical Group PA Family Medicine CurrentSince Jan 1, 1989 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

Verify at the official NPI Registry.