Mario Charles Colletti, M.D.

Key facts

NPI

1043449671

Entity type

Individual (NPI type 1)

Primary specialty

Pediatric Critical Care Medicine Physician 2080P0203X

License

25MA10146800 (NJ)

Practice address

703 Main St
Paterson, NJ 07503

Phone

(973) 972-4300

NPI assigned

Jul 2, 2009

Sex

Male

Sole proprietor

No

Organizations & group practices 7

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

• Saint Peter'S University Hospital General Acute Care Hospital · New Brunswick, NJ · NPI 1114924834
  Medicare reassignment NPD NJ
• St Josephs Medical Group PC Internal Medicine Physician · Paterson, NJ · NPI 1205425519
  Medicare reassignment NPD NJ
• St. Joseph'S Healthcare, Inc. Internal Medicine Physician · Paterson, NJ · NPI 1497791297
  Medicare reassignment NPD NJ
• University Physician Associates of New Jersey Inc Pediatrics Physician · Newark, NJ · NPI 1679583272
  Medicare reassignment NPD NJ
• Saint Peter'S University Hospital Clinical Psychologist · New Brunswick, NJ · NPI 1376079590
  NPD
• University Physician Associates of New Jersey Inc Internal Medicine Physician · Newark, NJ · NPI 1760492367
  NPD
• St Josephs University Medical Center Inc. General Acute Care Hospital · Paterson, NJ · NPI 1669462420
  NPD (past)

Medicare participation

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/8568/brand/1/csg/1/fhir/r4

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 22, 2018.

{
    "created_epoch": "1246492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529625600000",
    "number": "1043449671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 BERRY DR",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074703812",
            "telephone_number": "631-767-6552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 MAIN ST",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "07503",
            "telephone_number": "973-972-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLETTI",
        "first_name": "MARIO",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-02",
        "last_updated": "2018-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "NJ",
            "license": "25MA10146800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Paterson, NJ · Pediatric Critical Care Medicine Physician in New Jersey