DR. EDUARDO SEMBRANO M.D.
NPI 1326017567
Pediatrics - Pediatric Pulmonology in Long Branch, NJ
NPI Status: Active since March 17, 2006
Contact Information
279 3RD AVE
SUITE 604
LONG BRANCH, NJ
ZIP 07740
Phone: (732) 222-4474
Fax: (732) 222-4472
- Individual
- Male
- Pediatrics
- Pediatric Pulmonology
- Accepts Insurance
- PECOS Enrolled
About EDUARDO SEMBRANO
This page provides the complete NPI Profile along with additional information for Eduardo Sembrano, a pediatrician established in Long Branch, New Jersey with a medical specialization in Pediatrics, focusing in pediatric pulmonology . The healthcare provider is registered in the NPI registry with number 1326017567 assigned on March 2006. The practitioner's primary taxonomy code is 2080P0214X with license number 25MA08145100 (NJ). The provider is registered as an individual and his NPI record was last updated 13 years ago.
- NPI
- 1326017567
- Provider Name
- DR. EDUARDO SEMBRANO M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 279 3RD AVE SUITE 604 LONG BRANCH, NJ 07740
- Location Phone
- (732) 222-4474
- Location Fax
- (732) 222-4472
- Mailing Address
- PO BOX 8000 DEPT 596 BUFFALO, NY 14267
- Mailing Phone
- (866) 295-0041
- Mailing Fax
- (732) 222-4472
- Is Sole Proprietor?
- No
- Enumeration Date
- 03-17-2006
- Last Update Date
- 02-13-2013
- Code Navigator
A pediatrician like Eduardo Sembrano is a physician who has completed a pediatric residency and is board-certified or board-eligible in a pediatric specialty. Pediatric care providers are trained to care for newborns, infants, children and adolescents. A pediatrician could perform physical exams, manage vaccinations, monitor development milestones, diagnose illnesses, infections, injuries or other health problems, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Pediatrics Pediatric Pulmonology
- Taxonomy Code
- 2080P0214X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 25MA08145100
- License State
- NJ
- Taxonomy Description
- A pediatrician dedicated to the prevention and treatment of all respiratory diseases affecting infants, children and young adults. This specialist is knowledgeable about the growth and development of the lung, assessment of respiratory function in infants and children, and experienced in a variety of invasive and noninvasive diagnostic techniques.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Everyday Gold - HMO
- Everyday Gold + Vision + Adult Dental - HMO
- Focused Silver - HMO
- Focused Silver + Vision + Adult Dental - HMO
- Standard Expanded Bronze - HMO
- Standard Expanded Bronze + Vision + Adult Dental - HMO
- Standard Gold - HMO
- Standard Gold + Vision + Adult Dental - HMO
- Standard Silver - HMO
- Standard Silver + Vision + Adult Dental - HMO
- Clear Gold - EPO
- Clear Gold + Vision + Adult Dental - EPO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Elite Silver - EPO
- Elite Silver + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Focused Silver - EPO
- Focused Silver + Vision + Adult Dental - EPO
- Principal Bronze HSA - EPO
- Principal Bronze HSA + Vision + Adult Dental - EPO
- Standard Expanded Bronze - EPO
- Standard Expanded Bronze + Vision + Adult Dental - EPO
- Standard Gold - EPO
- Standard Gold + Vision + Adult Dental - EPO
- Standard Silver - EPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 104348 | MEDICARE PIN (08) | NJ | |
| G56293 | MEDICARE UPIN (02) | NJ | |
| 7446209 | MEDICAID (05) | NJ |
Medicare Participation & PECOS Enrollment Status
Eduardo Sembrano is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1326017567, we treat the final digit (7) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 53. The final step is to find the difference between that total and the next multiple of ten (60 - 53 = 7).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 53 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
LONG BRANCH, NJ 07740
LONG BRANCH, NJ 07740
LONG BRANCH, NJ 07740
LONG BRANCH, NJ 07740
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1326017567, enumerated as an "individual" on March 17, 2006.
The provider is located at 279 3RD AVE SUITE 604 LONG BRANCH, NJ 07740 and the phone number is (732) 222-4474.
Pediatrics with taxonomy code 2080P0214X and a focus in Pediatric Pulmonology.
The provider might be accepting Accepts: Ambetter Health, Ambetter Health of Delaware,. Please consult your insurance carrier or call the provider to verify.
