Misael Dimatulac, NURSE PRACTITIONER

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

343384 Issued in NY

Practice address

43 Maple Dr
Hazlet, NJ 07730-1333

Phone

(646) 525-9621

NPI assigned

Aug 17, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: mdimatulac1339317@nychhc.direct-ci.com

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

{
    "created_epoch": "1534464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534464000000",
    "number": "1043790165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 MAPLE DR",
            "city": "HAZLET",
            "state": "NJ",
            "postal_code": "077301333",
            "telephone_number": "646-525-9621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 MAPLE DR",
            "city": "HAZLET",
            "state": "NJ",
            "postal_code": "077301333",
            "telephone_number": "646-525-9621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMATULAC",
        "first_name": "MISAEL",
        "name_prefix": "Mr.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-08-17",
        "last_updated": "2018-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "343384",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robyn F Derespinis, LCSW
• James Thomas Devone, LPC
• Michaela Diaz
• Digestive Disease Specialists of Central Jersey P.C.
• Daniel Digiacomo, DDS
• Alexandria Dominici, SLS
• Shannon Margaret Dorgan
• Anthony Bishoy George Doss, DMD
• Dr Dinesh Shah MD
• Dr. Mahmoud H. Aly, P.C.

• Family Nurse Practitioner in Hazlet, NJ
• Providers in Hazlet, NJ by specialty
• Family Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.