Active NPI
Ralph Campitiello, D.M.D.
- Dentist
- Pompton Lakes, NJ
National Provider Identifier
1033150248
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 11612
- Practice address
- 518 Hamburg Turnpike
Pompton Lakes, NJ 07442-1430 - Phone
- (973) 835-0193
- Fax
- (973) 835-0113
- NPI assigned
- Jun 9, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 11612 | NJ | Primary |
Addresses
Primary practice location
518 Hamburg Turnpike
Pompton Lakes, NJ 07442-1430
Mailing address
518 Hamburg Tpke
Pompton Lakes, NJ 07442-1430
Phone (973) 835-0193
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151202000833 | NJ | Order and Referring Only - Other (Physician) | 7416257183 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11612 | NJ | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149811200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1307491200000",
"number": "1033150248",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "518 HAMBURG TPKE",
"city": "POMPTON LAKES",
"state": "NJ",
"postal_code": "074421430",
"telephone_number": "973-835-0193",
"fax_number": "973-835-0113"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "518 HAMBURG TURNPIKE",
"city": "POMPTON LAKES",
"state": "NJ",
"postal_code": "074421430",
"telephone_number": "973-835-0193",
"fax_number": "973-835-0113"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMPITIELLO",
"first_name": "RALPH",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-09",
"last_updated": "2011-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NJ",
"license": "11612",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pompton Lakes, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.