Individual provider Active NPI

Abgiale Alexes Roberts, FNP

  • Family Medicine Physician
  • Newark, NJ
National Provider Identifier
1932882016
Registry record updated Aug 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
26NJ14884600 Issued in NJ
Practice address
147 Hillside Ave
Newark, NJ 07108-2409
Phone
(862) 755-5889
NPI assigned
Aug 7, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 26NJ14884600 NJ Primary

Addresses

Primary practice location

147 Hillside Ave
Newark, NJ 07108-2409

Mailing address

147 Hillside Ave
Newark, NJ 07108-2409
Phone (862) 755-5889

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240207000195 NJ Practitioner - Nurse Practitioner 9436592433 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
RT Bock MD Consultancy, LLCGroup PAC ID 4183646151, 6 clinicians

Practice addresses (Care Compare)

91 Union Valley Rd
Newfoundland, NJ 07435-1603
Phone (201) 492-4987

Hospital & facility affiliations

  • Patient Care Home health agency, West Orange, NJ, CCN 317060

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
RT Bock MD Consultancy, LLC Single Specialty CurrentSince Mar 18, 2024 Accepting new patients
Pradip S. Shah, M.D. Single Specialty PastSince May 14, 2023 Accepting new patients

Organizations & group practices 3

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 1

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": "1691366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691366400000",
    "number": "1932882016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "147 HILLSIDE AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071082409",
            "telephone_number": "862-755-5889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 HILLSIDE AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071082409",
            "telephone_number": "862-755-5889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "ABGIALE",
        "middle_name": "ALEXES",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-07",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "26NJ14884600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.