Individual provider Active NPI

Edward Thomas Swibinski, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Cherry Hill, NJ
National Provider Identifier
1700844784
Registry record updated Oct 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
25MA03470200 Issued in NJ
Practice address
1210 Brace Rd
Suite 107
Cherry Hill, NJ 08034-3213
Phone
(856) 795-3597
Fax
(856) 795-7590
NPI assigned
May 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 25MA03470200 NJ Primary

Addresses

Primary practice location

1210 Brace Rd
Suite 107
Cherry Hill, NJ 08034-3213

Mailing address

1210 Brace Rd
Suite 107
Cherry Hill, NJ 08034-3213
Phone (856) 795-3597

Other identifiers 1

IdentifierTypeStateIssuer
1478001MedicaidNJ

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
I20051026000881 NJ Practitioner - EndocrinologyPractitioner - Internal Medicine 5395762629 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA03470200NJMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
CMC Department of Medicine Group PA CurrentSince Apr 1, 2001 Accepting new patients

Locations

1 Federal St
Ste SW200
Camden, NJ 08103
Phone (856) 356-4920

3 Cooper Plz
Rm 215
Camden, NJ 08103
Phone (856) 342-2439

3 Cooper Plz
Rm 311
Camden, NJ 08103
Phone (856) 342-2034

1210 Brace Rd
Ste 107
Cherry Hill, NJ 08034
Phone (856) 321-0012

310 Salem Woodstown Rd
Salem, NJ 08079
Phone (856) 339-6054

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286841600000",
    "number": "1700844784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 BRACE RD",
            "address_2": "SUITE 107",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080343213",
            "telephone_number": "856-795-3597",
            "fax_number": "856-795-7590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 BRACE RD",
            "address_2": "SUITE 107",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080343213",
            "telephone_number": "856-795-3597",
            "fax_number": "856-795-7590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWIBINSKI",
        "first_name": "EDWARD",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-01",
        "last_updated": "2010-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NJ",
            "license": "25MA03470200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1478001",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cherry Hill, NJ

Sources for this page

Verify at the official NPI Registry.