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EVAN D. O'BRIEN, M.D., P.C
NPI 1619126539
Physician Assistant - Surgical in West Deptford, NJ

Active since September 16, 2008
1225 N BROAD ST, SUITE 3, WEST DEPTFORD, NJ 08096(856) 845-0707(856) 845-0082 Get Directions Write a Review

NPPES record last updated: June 11, 2009. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Evan D. O'brien, M.d., P.c NPPES

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

EVAN D. O'BRIEN, M.D., P.C (NPI 1619126539) is a healthcare organization registered as a surgical in West Deptford, New Jersey and active in the NPI registry since September 2008. The organization lists Kimberly Owens, Billing Manager, as its authorized official.

NPPES Registry Identity

NPI1619126539
Entity TypeOrganization
Primary Taxonomy363AS0400X
Legal Business NameEVAN D. O'BRIEN, M.D., P.C
Location Address1225 N BROAD ST, SUITE 3West Deptford, NJ 08096-1203
Mailing Address1225 N Broad St, Suite 3West Deptford, NJ 08096-1203 · (856) 845-0707
Phone(856) 845-0707
Fax(856) 845-0082
Organization SubpartNo
Authorized OfficialKimberly OwensBilling Manager · (856) 845-0707
Enumeration DateSeptember 16, 2008
Last NPPES UpdateJune 11, 2009
✔ NPI 1619126539 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
Licenses✔ Licensed in NJ · 25MP00021200✔ Licensed in NJ · 25MP00100300
Also ListedOrthopaedic Surgery · Orthopaedic Surgery of the SpineTaxonomy 207XS0117X · License MA63525 (NJ)
Also ListedPhysical Medicine & Rehabilitation · Pain MedicineTaxonomy 2081P2900X · License 25MA07777400 (NJ)
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License 26NJ00027700 (NJ)
1225 N BROAD ST, West Deptford, NJ 08096
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Other Identifiers 1

Medicare NSC6191490001NJ

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Evan D. O'brien, M.d., P.c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by February 28, 2027

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateNew JerseyEnrollment IDO20080925000098Non-DME Part B · Clinic/Group PracticeDue dateFebruary 28, 2027
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Evan D. O'brien, M.D., P.C, which bills Medicare for the services this clinician delivers.

Clinician (1)

Evan O'brien, M.D.
Orthopedic Surgery
NPI 1740381185
1225 N BROAD ST STE 3
West Deptford, NJ 08096
(856) 845-0707
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Evan D. O'brien, M.D., P.C's NPI number?

The NPI number for Evan D. O'brien, M.D., P.C is 1619126539. It was assigned to this organization in the NPPES registry on September 16, 2008.

Where is Evan D. O'brien, M.D., P.C located?

Evan D. O'brien, M.D., P.C is located at 1225 N Broad St Suite 3, West Deptford, NJ 08096. The listed phone number is (856) 845-0707.

What is Evan D. O'brien, M.D., P.C's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Is Evan D. O'brien, M.D., P.C enrolled in Medicare?

Yes. Evan D. O'brien, M.D., P.C is registered in the Medicare PECOS enrollment system.

When is Evan D. O'brien, M.D., P.C's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (New Jersey, Clinic/Group Practice) is due for revalidation by February 28, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Evan D. O'brien, M.D., P.C?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Orthopedic Surgery) reassigns their Medicare billing to Evan D. O'brien, M.D., P.C. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Evan D. O'brien, M.D., P.C was last updated on June 11, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.