Individual provider Active NPI

Arthur H Braunwell III, DO

  • Family Medicine Physician
  • Ship Bottom, NJ
National Provider Identifier
1821094640
Registry record updated Sep 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MB059243000 Issued in NJ
Practice address
901 Long Beach Blvd
Ship Bottom, NJ 08008-6301
Phone
(609) 361-2644
Fax
(609) 361-2469
NPI assigned
Jun 27, 2005
Last updated
Sep 16, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25MB059243000 NJ Primary

Addresses

Primary practice location

901 Long Beach Blvd
Ship Bottom, NJ 08008-6301

Mailing address

2290 W County Line Rd
Jackson, NJ 08527-2267
Phone (732) 942-4455

Other identifiers 1

IdentifierTypeStateIssuer
5523702MedicaidNJ

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
I20040715000368 NJ Practitioner - Family Practice 4486633328 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Somc Medical Group PCGroup PAC ID 4587799358, 28 clinicians

Practice addresses (Care Compare)

901 Long Beach Blvd
Ship Bottom, NJ 08008-6301
Phone (609) 361-2677

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.09 of 100Reported as apm
Quality
86.89
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MB059243000NJMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Somc Medical Group PC CurrentSince Apr 1, 2014 Accepting new patients
Ocean County Family Care, P.a. Current Accepting new patients

Locations

2125 Route 88 E
Brick, NJ 08724
Phone (732) 892-4548

701 S Main St
Forked River, NJ 08731
Phone (609) 250-4110

9 Mule Rd
Ste 11
Toms River, NJ 08755
Phone (732) 797-1535

9 Mule Rd
Ste E10
Toms River, NJ 08755
Phone (732) 370-4222

Interoperability endpoints

  • Direct secure messaging: arthur.braunwell@direct.hackensackmeridian.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1119830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410825600000",
    "number": "1821094640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2290 W COUNTY LINE RD",
            "city": "JACKSON",
            "state": "NJ",
            "postal_code": "085272267",
            "telephone_number": "732-942-4455",
            "fax_number": "732-942-4459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 LONG BEACH BLVD",
            "city": "SHIP BOTTOM",
            "state": "NJ",
            "postal_code": "080086301",
            "telephone_number": "609-361-2644",
            "fax_number": "609-361-2469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAUNWELL",
        "first_name": "ARTHUR",
        "middle_name": "H",
        "name_suffix": "III",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-27",
        "last_updated": "2014-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MB059243000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5523702",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ship Bottom, NJ

Sources for this page

Verify at the official NPI Registry.