NPIMap

Individual provider Active NPI

Richard M Mauriello, DO

  • Family Medicine Physician
  • Berlin, NJ
National Provider Identifier
1023012952
Registry record updated Oct 2, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MB32129 Issued in NJ
Practice address
175 Cross Keys Rd # 300a
Berlin, NJ 08009-9263
Phone
(856) 767-0077
Fax
(856) 767-6102
NPI assigned
Jun 9, 2005
Last updated
Oct 2, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MB32129 NJ Primary

Addresses

Primary practice location

175 Cross Keys Rd # 300a
Berlin, NJ 08009-9263

Mailing address

175 Cross Keys Rd # 300a
Berlin, NJ 08009-9263
Phone (856) 767-0077

Other identifiers 1

IdentifierTypeStateIssuer
MB32129OtherNJLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101030000023 NJ Practitioner - Family Practice 0042404493 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Advocare, LLCGroup PAC ID 3678562188, 383 clinicians

Practice addresses (Care Compare)

132 Grove St
Suite a
Haddonfield, NJ 08033-1224
Phone (856) 354-2211

175 Cross Keys Rd
Suite 300a
Berlin, NJ 08009-9263
Phone (856) 872-7055

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
MB32129NJMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advocare , LLC Family Medicine Past Accepting new patients
Community Neurology Associates PC Past Accepting new patients
Berlin Medical Assco Family Medicine Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: richard.mauriello@advocaredoctors.eclinicaldirectplus.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191283200000",
    "number": "1023012952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 CROSS KEYS RD # 300A",
            "city": "BERLIN",
            "state": "NJ",
            "postal_code": "080099263",
            "telephone_number": "856-767-0077",
            "fax_number": "856-767-6102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 CROSS KEYS RD # 300A",
            "city": "BERLIN",
            "state": "NJ",
            "postal_code": "080099263",
            "telephone_number": "856-767-0077",
            "fax_number": "856-767-6102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAURIELLO",
        "first_name": "RICHARD",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-09",
        "last_updated": "2007-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "MB32129",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "MB32129",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Berlin, NJ

Sources for this page

Verify at the official NPI Registry.