Organization Active NPI

Otakar R Hubschmann MD PA

  • Neurological Surgery Physician
  • West Orange, NJ
National Provider Identifier
1790990380
Registry record updated Dec 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
25MA0315500 Issued in NJ
Legal business name
OTAKAR R HUBSCHMANN MD PA
Practice address
101 Old Short Hills Rd
Suite 409
West Orange, NJ 07052-1000
Phone
(973) 322-6732
Fax
(973) 322-6545
NPI assigned
May 14, 2007
Last updated
Dec 18, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2023

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

Authorized official

Name
Maureen Mortell Koziol
Title
RN
Phone
(973) 322-6732

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 25MA0315500 NJ Primary

Addresses

Primary practice location

101 Old Short Hills Rd
Suite 409
West Orange, NJ 07052-1000

Mailing address

101 Old Short Hills Rd
Suite 409
West Orange, NJ 07052-1000
Phone (973) 322-6732

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050613000773 NJ Part B Supplier - Clinic/Group Practice 5395789267 Receives reassigned benefits from 2 practitioners
Practice locations: West Orange, NJ

National Provider Directory

National Provider Directory

Locations

101 Old Short Hills Rd
Ste 409
West Orange, NJ 07052
Phone (973) 322-6732

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/93462298-4bdc-4b5e-ab96-39df8bb9a9b2/

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702857600000",
    "number": "1790990380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 OLD SHORT HILLS RD",
            "address_2": "SUITE 409",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070521000",
            "telephone_number": "973-322-6732",
            "fax_number": "973-322-6545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 OLD SHORT HILLS RD",
            "address_2": "SUITE 409",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070521000",
            "telephone_number": "973-322-6732",
            "fax_number": "973-322-6545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OTAKAR R HUBSCHMANN MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-14",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-18",
        "status": "A",
        "authorized_official_last_name": "KOZIOL",
        "authorized_official_first_name": "MAUREEN",
        "authorized_official_middle_name": "MORTELL",
        "authorized_official_title_or_position": "RN",
        "authorized_official_telephone_number": "973-322-6732"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "NJ",
            "license": "25MA0315500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Orange, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.