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DR. GERALD EDWARD PFLUM M.D.
NPI 1386603066
Otolaryngology - Otolaryngology/Facial Plastic Surgery in Neptune, NJ

Active since March 21, 2006PECOS EnrolledAccepts Medicare Assignment
78.53/100
CMS Quality Rating
444 NEPTUNE BLVD, UNIT 12, NEPTUNE, NJ 07753(732) 775-1301(732) 775-0507 Get Directions Write a Review

NPPES record last updated: August 21, 2009. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Dr. Gerald Edward Pflum M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. GERALD EDWARD PFLUM M.D. (NPI 1386603066) is an individual otolaryngology/facial plastic surgery provider in Neptune, New Jersey, licensed in New Jersey (25MA032941) and active in the NPI registry since March 2006. He is enrolled in Medicare PECOS, is affiliated with Jersey Shore University Medical Center, and is a graduate of Loyola University Of Chicago, Stritch School Of Medicine (1972).

NPPES Registry Identity

NPI1386603066
Entity TypeIndividualMale
Primary Taxonomy207YX0905X
Provider Legal NameDR. GERALD EDWARD PFLUMCredential: M.D.
Location Address444 NEPTUNE BLVD, UNIT 12Neptune, NJ 07753-4121
Mailing Address444 Neptune Blvd, Unit 12Neptune, NJ 07753-4121 · (732) 775-1301 · Fax (732) 775-0507
Phone(732) 775-1301
Fax(732) 775-0507
Sole ProprietorYes
Medical School CMSLoyola University Of Chicago, Stritch School Of MedicineGraduated 1972
Enumeration DateMarch 21, 2006
Last NPPES UpdateAugust 21, 2009
✔ NPI 1386603066 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOtolaryngology · Otolaryngology/Facial Plastic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207YX0905X
License✔ Licensed in NJ · 25MA032941
Definition

An otolaryngologist who specializes in the diagnosis and surgical treatment of head and neck conditions.

444 NEPTUNE BLVD, Neptune, NJ 07753
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Other Identifiers 14

Other7802221607650NJ · Horizon Bs
Other222160765NJ · United Healthcare
Other222160765077530000NJ · Tri Care
Medicare PIN455749NJ
Other222160765001NJ · Qualcare
OtherF02133NJ · Health Net Of The Northea
Other32249NJ · Empire Bs
Medicare UPINC55752NJ
Other2221607650003NJ · Cigna
OtherMS249NJ · Oxford
Other0441233000NJ · Amerihealth
Medicaid2003902NJ
Other0049667NJ · Aetna
Other0094161NJ · Ghi

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Gerald Edward Pflum M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2961561766
PECOS Enrollment IDI20081107000782
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 9

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Removal of impacted ear wax 69210
Impacted ear wax removal is a safe procedure to clear blockages in the ear canal caused by hardened ear wax. A healthcare professional uses specialized tools or a gentle irrigation method to loosen and remove the wax, improving hearing and alleviating discomfort.
275 services186 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
256 services170 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
117 services93 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
59 services59 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
55 services55 patients
Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing G0268
This procedure involves a doctor removing impacted earwax (cerumen) from one or both ears. This is often done on the same day as hearing function tests. The process helps to clear the ear canal, improving hearing and ensuring accurate test results.
47 services47 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Jersey Shore University Medical Center

Acute Care Hospitals · Neptune, NJ
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number310073
Location1945 State Route 33Neptune, NJ 07753 · Monmouth County
Emergency services Birthing friendly

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

78.53/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality57.06
Improvement Activities40

Reported Quality Measures

Documentation of Current Medications in the Medical Record
100%995 patients5/55-star benchmark: 100%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Patients screened: 100% · 174 patients
100%174 patients
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 15

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

GERALD E PFLUM MD PA
Otolaryngology (Otolaryngology/Facial Plastic Surgery)
444 NEPTUNE BLVD, UNIT 12
NEPTUNE, NJ 07753
Monmouth County (732) 775-1301
MRS. LAURIE E SCHERTZ
Audiologist
444 NEPTUNE BLVD, UNIT 12
NEPTUNE, NJ 07753
Monmouth County (732) 775-1301
INTERNAL MEDICINE INSTITUTE OF NEW JERSEY, LLC
Internal Medicine
444 NEPTUNE BLVD, SUITE 13
NEPTUNE, NJ 07753
Monmouth County (732) 455-8090
KENNETH B HARRIS MD
Internal Medicine (Cardiovascular Disease)
444 NEPTUNE BLVD
NEPTUNE, NJ 07753
Monmouth County (732) 775-5300
DR. MARC E COLMER M.D.
Specialist
444 NEPTUNE BLVD
NEPTUNE, NJ 07753
Monmouth County (732) 775-5300
EDWARD J CHOI M.D.
Internal Medicine (Cardiovascular Disease)
444 NEPTUNE BLVD
NEPTUNE, NJ 07753
Monmouth County (732) 775-5300
DR. PETER G LAPMAN MD
Internal Medicine (Cardiovascular Disease)
444 NEPTUNE BLVD
NEPTUNE, NJ 07753
Monmouth County (732) 775-5300
ANNE ROSANO M.A. FAAA
Audiologist
444 NEPTUNE BLVD, UNIT 1
NEPTUNE, NJ 07753
Monmouth County (732) 775-1700

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Gerald Pflum's NPI number?

The NPI number for Gerald Pflum is 1386603066. It was assigned to this individual provider in the NPPES registry on March 21, 2006.

Where is Gerald Pflum located?

Gerald Pflum practices at 444 Neptune Blvd Unit 12, Neptune, NJ 07753. The listed phone number is (732) 775-1301.

What is Gerald Pflum's specialty?

The primary specialty registered for this NPI is Otolaryngology, specializing in Otolaryngology/Facial Plastic Surgery, with taxonomy code 207YX0905X.

Is Gerald Pflum enrolled in Medicare?

Yes. Gerald Pflum is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Gerald Pflum accept?

Health plans from Ambetter Health and Ambetter Health of Delaware list Gerald Pflum as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Gerald Pflum affiliated with any hospitals?

According to CMS data, Gerald Pflum is affiliated with Jersey Shore University Medical Center.

When was this NPI record last updated?

The NPPES record for Gerald Pflum was last updated on August 21, 2009. NPI Profile syncs with the weekly NPPES data releases published by CMS.