Fern Elyse Kopp Mulberg, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

25MB05948700 Issued in NJ

Practice address

110 Rehill Ave
Somerville, NJ 08876-2519

Phone

(908) 685-2900

Fax

(732) 463-5512

NPI assigned

Nov 19, 2010

Last updated

Aug 8, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

Specialty

Family Practice

Education

New York College of Osteo Medicine of New York Institute of Technology, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rwjbh Primary Care ServicesGroup PAC ID 0749699346, 266 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Robert Wood Johnson University Hospital - Somerset Hospital, Somerville, NJ, CCN 310048

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: fkoppmulberg15020@epicdirect.rwjbh.org
• FHIR API: https://fhir-myrecord.cerner.com/r4/xYxhuXIFsLg59PaSNJv_x-piAtPKX3W8/

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.

• Rwjbh Primary Care Services

  • Internal Medicine Physician
  • West Orange, NJ
  • NPI 1265037501

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Cooper Family Medicine, PC

  • Family Medicine Physician
  • Cherry Hill, NJ
  • NPI 1649217175
  Medicare reassignment NPD
• Cooper Physician Offices, PA

  • Internal Medicine Physician
  • Camden, NJ
  • NPI 1154369510
  Medicare reassignment NPD
• Cooper Family Medicine PC

  • Family Medicine Physician
  • Moorestown, NJ
  • NPI 1093929895
  Medicare reassignment
• Cooper Family Medicine

  • Family Medicine Physician
  • Camden, NJ
  • NPI 1033312939
  NPD (past)
• Robert Wood Johnson University Hospital Inc

  dba Robert Wood Johnson University Hospital Somerset

  • General Acute Care Hospital
  • Somerville, NJ
  • NPI 1003236878
  NPD (past)
• Suburban Radiologists, S.C.

  • Diagnostic Radiology Physician
  • La Grange, IL
  • NPI 1386665396
  NPD (past)

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

• Robert Wood Johnson University Hospital Inc

  dba Robert Wood Johnson University Hospital Somerset

  • General Acute Care Hospital
  • Somerville, NJ
  • NPI 1003236878
  Care Compare affiliation

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

{
    "created_epoch": "1290124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723075200000",
    "number": "1699077909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "379 CAMPUS DR FL 4",
            "city": "SOMERSET",
            "state": "NJ",
            "postal_code": "088731161",
            "telephone_number": "732-937-8939",
            "fax_number": "732-418-8372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 REHILL AVE",
            "city": "SOMERVILLE",
            "state": "NJ",
            "postal_code": "088762519",
            "telephone_number": "908-685-2900",
            "fax_number": "732-463-5512"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "630 Mantua Pike",
            "address_purpose": "LOCATION",
            "city": "Woodbury",
            "state": "NJ",
            "postal_code": "080963233",
            "country_code": "US",
            "telephone_number": "856-812-2220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOPP MULBERG",
        "first_name": "FERN",
        "middle_name": "ELYSE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-19",
        "last_updated": "2024-08-08",
        "certification_date": "2024-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS008386L",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "H0076671",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MB05948700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Katelynn Kix, ED.S.
• Samantha A Knieser, AGACNP-BC
• Kelly Koeller, LCSW
• Caitlin Kondroski
• Pamela B Kopelove, MD
• Aleksandra Kordal, MSW, LCSW
• Magdalini Kostidakis, PT, DPT
• Jessica Brynn Kowal, LAC
• Karen Zielinski Kowalski, MPH, OTR
• Ashleigh Kozicz, PA-C

• Family Medicine Physician in Somerville, NJ
• Providers in Somerville, NJ by specialty
• Family Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.