Jack E. Ebani, MD

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

25MA04538800 Issued in NJ

Practice address

1820 Corlies Avenue
Neptune, NJ 07753

Phone

(732) 774-4551

Fax

(732) 774-8933

NPI assigned

Dec 13, 2006

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 1

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

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.

• Jack Ebani MD Imrt LLC

  • Radiation Oncology Physician
  • Lakewood, NJ
  • NPI 1093984676
  NPD (past) Authorized official

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205712000000",
    "number": "1962563932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1820 CORLIES AVENUE",
            "city": "NEPTUNE",
            "state": "NJ",
            "postal_code": "07753",
            "telephone_number": "732-774-4551",
            "fax_number": "732-774-8933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1820 CORLIES AVENUE",
            "city": "NEPTUNE",
            "state": "NJ",
            "postal_code": "07753",
            "telephone_number": "732-774-4551",
            "fax_number": "732-774-8933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBANI",
        "first_name": "JACK",
        "middle_name": "E.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2008-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NJ",
            "license": "25MA04538800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5043603",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael C. Dyce, MD
• Ea Health - New Jersey LLC
• Santhosh Eapen, MD
• Andrea Earley, DNP, CRNA
• Margaret Eason, DDS
• Kathryn M Eckert, DO
• Deanna Edwards, PA-C
• Ranyelenu Efobi
• Nicole Egan, APN
• Kaitlin Nicole Eipel, PA-C

• Urology Physician in Neptune, NJ
• Providers in Neptune, NJ by specialty
• Urology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2008; 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.