Individual provider Active NPI

David Kountz

  • Internal Medicine Physician
  • New Brunswick, NJ
National Provider Identifier
1679645931
Registry record updated Feb 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MA64086 Issued in NJ
Practice address
125 Paterson St
Clinical Academic Building - Suite 5100a
New Brunswick, NJ 08901-1962
Phone
(732) 235-6968
NPI assigned
Nov 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MA64086 NJ Primary

Addresses

Primary practice location

125 Paterson St
Clinical Academic Building - Suite 5100a
New Brunswick, NJ 08901-1962

Mailing address

66 W Gilbert St
2ND Floor
Tinton Falls, NJ 07701-4947
Phone (732) 212-0051

Other identifiers 1

IdentifierTypeStateIssuer
0641600MedicaidNJ

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
I20231205000127 NJ Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 5193760171

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA64086NJMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202256000000",
    "number": "1679645931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 W GILBERT ST",
            "address_2": "2ND FLOOR",
            "city": "TINTON FALLS",
            "state": "NJ",
            "postal_code": "077014947",
            "telephone_number": "732-212-0051",
            "fax_number": "732-212-0713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 PATERSON ST",
            "address_2": "CLINICAL ACADEMIC BUILDING - SUITE 5100A",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089011962",
            "telephone_number": "732-235-6968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOUNTZ",
        "first_name": "DAVID",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2008-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "MA64086",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0641600",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Brunswick, NJ

Sources for this page

Verify at the official NPI Registry.