NPIMap

Individual provider Active NPI

Robert W Dickson III, MD

  • Internal Medicine Physician
  • Shiloh, NJ
National Provider Identifier
1851314017
Registry record updated Jan 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MA53365 Issued in NJ
Practice address
851 Main St
Shiloh, NJ 08353-8505
Phone
(856) 455-1464
Fax
(856) 455-6381
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 25, 2017

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 MA53365 NJ Primary

Addresses

Primary practice location

851 Main St
Shiloh, NJ 08353-8505

Mailing address

851 Main Street
PO Box 110
Shiloh, NJ 08353-0110
Phone (856) 455-1464

Other identifiers 2

IdentifierTypeStateIssuer
J2232OtherNJHORIZON
4540603MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050623000432 NJ Practitioner - Internal Medicine 4688619224 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Texas Medical School at San Antonio, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

851 Main St
Shiloh, NJ 08353-8505
Phone (856) 455-1464

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA53365NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dickson Inc Internal Medicine CurrentSince May 22, 1991 Accepting new patients
Inspira Medical Centers, Inc. Past Accepting new patients

Locations

851 Main St
Shiloh, NJ 08353
Phone (856) 455-1464

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 and National Provider Directory roles.

Hospital & facility affiliations 11

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": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485302400000",
    "number": "1851314017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "851 MAIN STREET",
            "address_2": "PO BOX 110",
            "city": "SHILOH",
            "state": "NJ",
            "postal_code": "083530110",
            "telephone_number": "856-455-1464",
            "fax_number": "856-455-6381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "851 MAIN ST",
            "city": "SHILOH",
            "state": "NJ",
            "postal_code": "083538505",
            "telephone_number": "856-455-1464",
            "fax_number": "856-455-6381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKSON",
        "first_name": "ROBERT",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2017-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "MA53365",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON",
            "identifier": "J2232",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4540603",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shiloh, NJ

Sources for this page

Verify at the official NPI Registry.