Individual provider Active NPI

Thomas Grabiak, M.D.

  • Surgery Physician
  • Voorhees, NJ
National Provider Identifier
1710988852
Registry record updated Oct 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
25MA04602500 Issued in NJ
Practice address
805 Cooper Rd
Suite 2
Voorhees, NJ 08043-3814
Phone
(856) 882-1201
Fax
(856) 424-2218
NPI assigned
Aug 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 25MA04602500 NJ Primary

Addresses

Primary practice location

805 Cooper Rd
Suite 2
Voorhees, NJ 08043-3814

Mailing address

500 Grove St
Suite 100
Haddon Heights, NJ 08035-1761
Phone (856) 796-9200

Other identifiers 1

IdentifierTypeStateIssuer
2098903MedicaidNJ

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tgrabiak19465@directvirtua.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA04602500NJMDSurgery Physician

Interoperability endpoints

  • Direct secure messaging: tgrabiak19465@directvirtua.org

NPI Registry JSON

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

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603065600000",
    "number": "1710988852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 GROVE ST",
            "address_2": "SUITE 100",
            "city": "HADDON HEIGHTS",
            "state": "NJ",
            "postal_code": "080351761",
            "telephone_number": "856-796-9200",
            "fax_number": "856-796-9397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 COOPER RD",
            "address_2": "SUITE 2",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080433814",
            "telephone_number": "856-882-1201",
            "fax_number": "856-424-2218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRABIAK",
        "first_name": "THOMAS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NJ",
            "license": "25MA04602500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2098903",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tgrabiak19465@directvirtua.org",
            "affiliation": "N",
            "address_1": "805 Cooper Rd",
            "address_2": "Suite 2",
            "city": "Voorhees",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080433814",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Voorhees, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.