NPIMap

Organization Active NPI

Robert I Greenblatt MD PA

  • Gastroenterology Physician
  • Union, NJ
National Provider Identifier
1902093560
Registry record updated Dec 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
25MA04478800 Issued in NJ
Legal business name
ROBERT I GREENBLATT MD PA
Practice address
2333 Morris Ave
Suite B6
Union, NJ 07083-5752
Phone
(908) 964-1144
Fax
(908) 964-7646
NPI assigned
Sep 27, 2007
Last updated
Dec 13, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2011

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

Authorized official

Name
Robert I Greenblatt, MDNPI 1861580433
Title
Owner
Phone
(908) 964-1144

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X 25MA04478800 NJ Primary

Addresses

Primary practice location

2333 Morris Ave
Suite B6
Union, NJ 07083-5752

Mailing address

2333 Morris Ave
Suite B6
Union, NJ 07083-5752
Phone (908) 964-1144

Other identifiers 1

IdentifierTypeStateIssuer
0237001MedicaidNJ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111214000159 NJ Part B Supplier - Clinic/Group Practice 7315112711 Receives reassigned benefits from 5 practitioners
Practice locations: Kenilworth, NJ; Linden, NJ; Union, NJ

National Provider Directory

National Provider Directory

Locations

515 N Wood Ave
Ste 202A
Linden, NJ 07036
Phone (908) 486-8080

2333 Morris Ave
Ste B6
Union, NJ 07083
Phone (908) 964-1144

Practitioners & affiliated clinicians

Practitioners 12

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": "1190851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323734400000",
    "number": "1902093560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2333 MORRIS AVE",
            "address_2": "SUITE B6",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070835752",
            "telephone_number": "908-964-1144",
            "fax_number": "908-964-7646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2333 MORRIS AVE",
            "address_2": "SUITE B6",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070835752",
            "telephone_number": "908-964-1144",
            "fax_number": "908-964-7646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT I GREENBLATT MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-27",
        "last_updated": "2011-12-13",
        "status": "A",
        "authorized_official_last_name": "GREENBLATT",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "908-964-1144",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NJ",
            "license": "25MA04478800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0237001",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Union, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2011; 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.