Robert Glenn Fortin, M.D.

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

MA055583 Issued in NJ

Practice address

503 Cranbury Rd
East Brunswick, NJ 08816-3612

Phone

(732) 390-8400

Fax

(732) 390-8970

NPI assigned

Mar 17, 2006

Last updated

Mar 15, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: robert.fortin@advocaredoctors.eclinicaldirectplus.com

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.

• Advocare, LLC

  • Pediatrics Physician
  • Marlton, NJ
  • NPI 1770538696
  Medicare reassignment NPD
• Advocare , LLC

  dba Advocare Berlin Medical Associates (DME)

  • Internal Medicine Physician
  • Manahawkin, NJ
  • NPI 1912762162
  NPD
• Advocare , LLC

  dba Advocare Tiefenbrunn Fortin & Tuck Pediatrics

  • Pediatrics Physician
  • East Brunswick, NJ
  • NPI 1649030784
  NPD (past)
• Advocare, LLC

  dba Advocare Merchantville Pediatrics

  • Pediatrics Physician
  • Cherry Hill, NJ
  • NPI 1780696732
  NPD (past)
• Tiefenbrunn & Fortin Pediatrics

  • Pediatrics Physician
  • East Brunswick, NJ
  • NPI 1760656532
  NPD (past)

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489536000000",
    "number": "1932178217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 CRANBURY RD",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088163612",
            "telephone_number": "732-390-8400",
            "fax_number": "732-390-8970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 CRANBURY RD",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088163612",
            "telephone_number": "732-390-8400",
            "fax_number": "732-390-8970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORTIN",
        "first_name": "ROBERT",
        "middle_name": "GLENN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-17",
        "last_updated": "2017-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "NJ",
            "license": "MA055583",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET ID",
            "identifier": "F06244",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QUALCARE/GHI NY ID",
            "identifier": "8222069",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED ID",
            "identifier": "1545372",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIP/PHCS ID",
            "identifier": "MA055583",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "222694202",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD ID",
            "identifier": "P2676733",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daniel Flynn, M.D.
• Gabriella Fogel
• Foholdings, LLC (Witlin Center for Advanced Eyecare)
• Cheng Fong, DDS, MA
• Foremost Health Consultants LLC
• Foundation Family Dentistry LLC
• Four Seasons Counseling Group LLC
• Four Seasons Family Dentistry, LLC
• Angelo Fouras, LCSW
• Patricia Anne Fox

• Pediatric Adolescent Medicine Physician in East Brunswick, NJ
• Providers in East Brunswick, NJ by specialty
• Pediatric Adolescent Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.