Individual provider Active NPI

Edward Rakler, PA-C

  • Physician Assistant
  • Elizabeth, NJ
National Provider Identifier
1609873231
Registry record updated Dec 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00107900 Issued in NJ
Practice address
500 Westfield Ave
Elizabeth, NJ 07208-1642
Phone
(908) 994-1500
NPI assigned
Jun 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 25MP00107900 NJ
Physician Assistant 363A00000X 25MP00107900 NJ Primary

Addresses

Primary practice location

500 Westfield Ave
Elizabeth, NJ 07208-1642

Mailing address

500 Westfield Ave
Elizabeth, NJ 07208-1642
Phone (908) 994-1500

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
I20050512000043 NJ Practitioner - Physician Assistant 6608816350 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

120 Elmora Ave
Elizabeth, NJ 07202-1625

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MP00107900NJMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Atlantic Professional Services of New Jersey, P.a. Physician Assistant Past Accepting new patients
Essex Emergency Physicians, PC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: edward.rakler@direct.meditouchehr.com

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": "1119916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292371200000",
    "number": "1609873231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 WESTFIELD AVE",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072081642",
            "telephone_number": "908-994-1500",
            "fax_number": "908-994-0035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 WESTFIELD AVE",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072081642",
            "telephone_number": "908-994-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAKLER",
        "first_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-28",
        "last_updated": "2010-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NJ",
            "license": "25MP00107900",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00107900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabeth, NJ

Sources for this page

Verify at the official NPI Registry.