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Mobile Medicare

Geriatric Medicine (Family Medicine) Physician in Clark, NJ · enumerated 2006 · authorized official Colleen Tiedemann, Office Manager.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1457460594

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Registry record

Entity type Organization (Type 2)
Legal business name Mobile Medicare
Practice address 67 Walnut Ave, Clark, NJ, 07066
Phone (732) 388-7300
Fax (732) 388-1330
Enumeration date Aug 30, 2006
Last updated in NPPES Aug 6, 2007

Taxonomy & classification

207QG0300X Geriatric Medicine (Family Medicine) Physician Allopathic & Osteopathic Physicians · License MB27483 (NJ) Primary
207QG0300X Geriatric Medicine (Family Medicine) Physician Allopathic & Osteopathic Physicians · License MB53933 (NJ) Secondary
207R00000X Internal Medicine Physician Allopathic & Osteopathic Physicians · License MB71509 (NJ) Secondary

Authorized official

Name Colleen Tiedemann
Title Office Manager
Phone (732) 388-7300

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

Read the full guide → Validate an NPI →

Frequently asked questions

What is the NPI number for Mobile Medicare?
The NPI for Mobile Medicare is 1457460594, a Type 2 (organization) record in the CMS NPPES registry.
Who is the authorized official for Mobile Medicare?
NPPES lists Colleen Tiedemann (Office Manager) as the authorized official for this organization.

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2007-08-06.