Individual provider Active NPI

Thomas K O'Brien, MD

  • Pediatrics Physician
  • Ocean, NJ
National Provider Identifier
1659342889
Registry record updated Dec 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
25MA06852300 Issued in NJ
Practice address
804 W Park Ave
Ocean, NJ 07712-7272
Phone
(732) 531-0010
Fax
(732) 493-0903
NPI assigned
Jan 27, 2006
Last updated
Dec 7, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 25MA06852300 NJ Primary

Addresses

Primary practice location

804 W Park Ave
Ocean, NJ 07712-7272

Mailing address

804 W Park Ave
Ocean, NJ 07712-7272
Phone (732) 531-0010

Other practice location 1

20 White Rd Ste D
Shrewsbury, NJ 07702-4039
Phone (732) 741-3400

Other identifiers 1

IdentifierTypeStateIssuer
8487502MedicaidNJ

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
I20181228000570 NJ Practitioner - Pediatric Medicine 3173868866 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA06852300NJMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advocare, LLC Pediatrics CurrentSince Jan 1, 2019 Accepting new patients
Advocare , LLC CurrentSince Jan 1, 2019 Accepting new patients
Advocare, LLC Pediatrics Past Accepting new patients
Advocare, LLC Pediatrics Past Accepting new patients

Locations

169 Mine Brook Rd
#P
Bernardsville, NJ 07924
Phone (908) 766-0034

132 Grove St
Ste A
Haddonfield, NJ 08033
Phone (856) 354-2211

401 Route 73 N
Ste 320
Marlton, NJ 08053
Phone (609) 471-1033

402 Lippincott Dr
Marlton, NJ 08053
Phone (410) 763-8787

Interoperability endpoints

  • Direct secure messaging: thomas.obrien@advocaredoctors.eclinicaldirectplus.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544140800000",
    "number": "1659342889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 W PARK AVE",
            "city": "OCEAN",
            "state": "NJ",
            "postal_code": "077127272",
            "telephone_number": "732-531-0010",
            "fax_number": "732-493-0903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 W PARK AVE",
            "city": "OCEAN",
            "state": "NJ",
            "postal_code": "077127272",
            "telephone_number": "732-531-0010",
            "fax_number": "732-493-0903"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20 White Rd Ste D",
            "address_purpose": "LOCATION",
            "city": "Shrewsbury",
            "state": "NJ",
            "postal_code": "077024039",
            "country_code": "US",
            "telephone_number": "732-741-3400",
            "fax_number": "732-741-3104",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "THOMAS",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-27",
        "last_updated": "2018-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA06852300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8487502",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocean, NJ

Sources for this page

Verify at the official NPI Registry.