NPIMap

Individual provider Active NPI

Daniel J Brouder, MD

  • Nephrology Physician
  • Brick, NJ
National Provider Identifier
1659313963
Registry record updated Mar 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
25MA07572700 Issued in NJ
Practice address
210 Jack Martin Blvd
Suite D-1
Brick, NJ 08724-7771
Phone
(732) 458-5067
Fax
(732) 458-4962
NPI assigned
Jun 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 25MA07572700 NJ Primary

Addresses

Primary practice location

210 Jack Martin Blvd
Suite D-1
Brick, NJ 08724-7771

Mailing address

210 Jack Martin Blvd
Suite D-1
Brick, NJ 08724-7771
Phone (732) 458-5067

Other identifiers 2

IdentifierTypeStateIssuer
0052078MedicaidNJ
P00053546OtherRAILROADMEDICARENUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040614000063 NJ Practitioner - NephrologyPractitioner - Internal Medicine 5890779482 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
State University of New York Downstate Medical Center, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northeast Kidney Care LLCGroup PAC ID 8921445032, 66 clinicians

Practice addresses (Care Compare)

201 Laurel Oak Rd
Suite B
Voorhees, NJ 08043-4424
Phone (856) 566-5478

210 Jack Martin Blvd
Suite D1
Brick, NJ 08724-7771
Phone (732) 458-5854

508 Lakehurst Rd
Suite 3a
Toms River, NJ 08755-8000
Phone (732) 341-4600

83 Hanover Rd
Suite 290
Florham Park, NJ 07932-1520
Phone (973) 736-2212

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Kidney Care LLC Nephrology CurrentSince Apr 1, 2024 Accepting new patients

Locations

210 Jack Martin Blvd
Ste D1
Brick, NJ 08724
Phone (732) 341-4600

83 Hanover Rd
Ste 290
Florham Park, NJ 07932
Phone (973) 259-0278

1301 Route 72 W
Ste 206
Manahawkin, NJ 08050
Phone (609) 978-9940

444 Neptune Blvd
Unit 5
Neptune, NJ 07753
Phone (732) 458-5854

508 Lakehurst Rd
Ste 3A
Toms River, NJ 08755
Phone (732) 341-4600

201 Laurel Oak Rd
#B
Voorhees, NJ 08043
Phone (856) 566-5478

Interoperability endpoints

  • Direct secure messaging: dbrouder17417@direct.acumenmd.com

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 10

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": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393977600000",
    "number": "1659313963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 JACK MARTIN BLVD",
            "address_2": "SUITE D-1",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087247771",
            "telephone_number": "732-458-5067",
            "fax_number": "732-458-4962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 JACK MARTIN BLVD",
            "address_2": "SUITE D-1",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087247771",
            "telephone_number": "732-458-5067",
            "fax_number": "732-458-4962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROUDER",
        "first_name": "DANIEL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2014-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NJ",
            "license": "25MA07572700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0052078",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROADMEDICARENUMBER",
            "identifier": "P00053546",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brick, NJ

Sources for this page

Verify at the official NPI Registry.