Individual provider Active NPI

Gregory R Novotny, DO

  • Internal Medicine Physician
  • Egg Harbor City, NJ
National Provider Identifier
1750315198
Registry record updated Sep 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MB05370500 Issued in NJ
Practice address
649 Cypress Point Dr
Egg Harbor City, NJ 08215-5124
Phone
(609) 442-4745
Fax
(609) 965-0229
NPI assigned
Jul 10, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 1, 2026

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 25MB05370500 NJ Primary

Addresses

Primary practice location

649 Cypress Point Dr
Egg Harbor City, NJ 08215-5124

Mailing address

649 Cypress Point Dr
Egg Harbor City, NJ 08215-5124
Phone (609) 442-4745

Other identifiers 1

IdentifierTypeStateIssuer
8060606MedicaidNJ

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
I20050706000941 NJ Practitioner - Internal Medicine 3173569662 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Atlanticare Physician Group, PA CurrentSince Dec 19, 2010 Accepting new patients
Atlanticare Physician Group PA Current Accepting new patients
Atlanticare Physician Group CurrentSince Dec 19, 2010 Accepting new patients
State of New Jersey Omb Centralized Payroll CurrentSince Jan 14, 2019 Accepting new patients
State of New Jersey Omb Centralized Payroll CurrentSince Jan 14, 2019 Accepting new patients

Locations

1401 Atlantic Ave
Atlantic City, NJ 08401
Phone (609) 441-7088

459 Route 9 S
Little Egg Harbor Twp, NJ 08087
Phone (609) 340-7815

65 W Jimmie Leeds Rd
Pomona, NJ 08240
Phone (609) 484-6414

1175 Dehirsch Ave
Woodbine, NJ 08270
Phone (609) 861-2164

Organizations & group practices 5

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": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788220800000",
    "number": "1750315198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "649 CYPRESS POINT DR",
            "city": "EGG HARBOR CITY",
            "state": "NJ",
            "postal_code": "082155124",
            "telephone_number": "609-442-4745",
            "fax_number": "609-965-0229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "649 CYPRESS POINT DR",
            "city": "EGG HARBOR CITY",
            "state": "NJ",
            "postal_code": "082155124",
            "telephone_number": "609-442-4745",
            "fax_number": "609-965-0229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOVOTNY",
        "first_name": "GREGORY",
        "middle_name": "R",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2026-09-01",
        "certification_date": "2026-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MB05370500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8060606",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Egg Harbor City, NJ

Sources for this page

Verify at the official NPI Registry.