Individual provider Active NPI

Jean Robert Darbouze, MD

  • Specialist
  • Jersey City, NJ
National Provider Identifier
1639201510
Registry record updated Jun 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
25MA05886000 Issued in NJ
Practice address
230 Bergen Ave
Jersey City, NJ 07305-1522
Phone
(201) 432-0809
Fax
(201) 432-0074
NPI assigned
Mar 9, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 25MA05886000 NJ Primary

Addresses

Primary practice location

230 Bergen Ave
Jersey City, NJ 07305-1522

Mailing address

230 Bergen Ave
Jersey City, NJ 07305-1522
Phone (201) 833-3948

Other identifiers 1

IdentifierTypeStateIssuer
110186731MedicaidNJ

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
I20050622000049 NJ Practitioner - Internal Medicine 3375588270 Practice locations: Jersey City, NJ

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

230 Bergen Ave
Jersey City, NJ 07305-1522
Phone (201) 432-0809

Hospital & facility affiliations

  • Jersey City Medical Center Hospital, Jersey City, NJ, CCN 310074

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA05886000NJMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Humc Opco LLC Current Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jdarbouze@direct.hobokenumc.md

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560988800000",
    "number": "1639201510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 BERGEN AVE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073051522",
            "telephone_number": "201-833-3948",
            "fax_number": "201-833-2513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 BERGEN AVE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073051522",
            "telephone_number": "201-432-0809",
            "fax_number": "201-432-0074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DARBOUZE",
        "first_name": "JEAN",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-09",
        "last_updated": "2019-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NJ",
            "license": "25MA05886000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110186731",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jersey City, NJ

Sources for this page

Verify at the official NPI Registry.