Individual provider Active NPI

Marvin A Kleinman, M.S., CCC-A

  • Audiologist-Hearing Aid Fitter
  • Roselle Park, NJ
National Provider Identifier
1609995307
Registry record updated Jul 9, 2007
On this page

OIG exclusion record

The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:

  • Section 1128a(1) exclusion effective Jan 20, 2016.

Matched on NPI only. Confirm current status with the OIG exclusions search before relying on it.

Key facts

NPPES NPI Registry
Primary specialty
Audiologist-Hearing Aid FitterTaxonomy code 237600000X
License
25MG00045100 Issued in NJ
Practice address
17 E Westfield Ave
Roselle Park, NJ 07204-2207
Phone
(908) 245-6699
NPI assigned
Mar 27, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist-Hearing Aid Fitter 237600000X 25MG00045100 NJ Primary

Addresses

Primary practice location

17 E Westfield Ave
Roselle Park, NJ 07204-2207

Mailing address

17 E Westfield Ave
Roselle Park, NJ 07204-2207
Phone (908) 245-6699

Other identifiers 1

IdentifierTypeStateIssuer
0619400MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
25MG00045100NJMDAudiologist-Hearing Aid Fitter

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Hearing Service, LLC Audiologist-Hearing Aid Fitter Past Accepting new patients

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": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1609995307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 E WESTFIELD AVE",
            "city": "ROSELLE PARK",
            "state": "NJ",
            "postal_code": "072042207",
            "telephone_number": "908-245-6699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 E WESTFIELD AVE",
            "city": "ROSELLE PARK",
            "state": "NJ",
            "postal_code": "072042207",
            "telephone_number": "908-245-6699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEINMAN",
        "first_name": "MARVIN",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "M.S., CCC-A",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-27",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "NJ",
            "license": "25MG00045100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0619400",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roselle Park, NJ

Sources for this page

Verify at the official NPI Registry.