Individual provider Active NPI

Michael J. Paul, D.O.

  • Interventional Pain Medicine Physician
  • Marlton, NJ
National Provider Identifier
1770528754
Registry record updated Mar 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
25MB07847800 Issued in NJ
Practice address
851 Route 73 N Ste D
Marlton, NJ 08053-1275
Phone
(856) 372-9422
Fax
(856) 409-0393
NPI assigned
Jun 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine Physician 208VP0014X 25MB07847800 NJ Primary

Addresses

Primary practice location

851 Route 73 N Ste D
Marlton, NJ 08053-1275

Mailing address

851 Route 73 N Ste D
Marlton, NJ 08053-1275
Phone (856) 372-9422

Other practice location 1

3069 English Creek Ave Ste 201
Egg Harbor Township, NJ 08234-9708
Phone (856) 372-9422

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
I20060130000341 NJ Practitioner - Physical Medicine and RehabilitationPractitioner - Interventional Pain Management 6709800287 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
South Jersey Rehab and Spine Inc Interventional Pain Medicine CurrentSince Jun 12, 2022 Accepting new patients
Fellowship Surgical Center LLC CurrentSince Mar 1, 2010 Accepting new patients
Neurosurgical & Spinal Specialists, LLC CurrentSince Apr 6, 2020 Accepting new patients

Locations

851 Route 73 N
Ste D
Marlton, NJ 08053
Phone (856) 372-9422

3829 Church Rd
#A
Mount Laurel, NJ 08054
Phone (856) 372-9422

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JEGHCD/Endpoint/JEGHCD

Organizations & group practices 3

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": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646784000000",
    "number": "1770528754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "851 ROUTE 73 N STE D",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080531275",
            "telephone_number": "856-372-9422",
            "fax_number": "856-409-0393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "851 ROUTE 73 N STE D",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080531275",
            "telephone_number": "856-372-9422",
            "fax_number": "856-409-0393"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3069 English Creek Ave Ste 201",
            "address_purpose": "LOCATION",
            "city": "Egg Harbor Township",
            "state": "NJ",
            "postal_code": "082349708",
            "country_code": "US",
            "telephone_number": "856-372-9422",
            "fax_number": "856-409-0393",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAUL",
        "first_name": "MICHAEL",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2022-03-09",
        "certification_date": "2022-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NJ",
            "license": "25MB07847800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marlton, NJ

Sources for this page

Verify at the official NPI Registry.