Individual provider Active NPI

John Lewis Saporito, MD

  • Otolaryngology Physician
  • Shrewsbury, NJ
National Provider Identifier
1063516441
Registry record updated Feb 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
25MA03949800 Issued in NJ
Practice address
1131 Broad Street
Ste 102
Shrewsbury, NJ 07702
Phone
(732) 389-2500
Fax
(732) 389-2820
NPI assigned
Sep 7, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 19, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 25MA03949800 NJ Primary

Addresses

Primary practice location

1131 Broad Street
Ste 102
Shrewsbury, NJ 07702

Mailing address

1131 Broad Street
Ste 102
Shrewsbury, NJ 07702
Phone (732) 389-2500

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100205000406 NJ Practitioner - Otolaryngology 4789727272 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Liberty Med Associates LLCGroup PAC ID 7416234075, 11 clinicians

Practice addresses (Care Compare)

999 Palmer Ave
Suite 1
Holmdel, NJ 07733-1088
Phone (732) 670-3313

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA03949800NJMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Liberty Med Associates LLC Otolaryngology CurrentSince Feb 6, 2018 Accepting new patients

Locations

999 Palmer Ave
Ste 1
Holmdel, NJ 07733
Phone (732) 670-3313

1 Riverview Plz
Red Bank, NJ 07701
Phone (732) 530-2204

1131 Broad St
Ste 103
Shrewsbury, NJ 07702
Phone (732) 389-2438

1131 Highway 35
Shrewsbury, NJ 07702
Phone (732) 389-3388

1131 Broad St
Ste 102
Shrewsbury, NJ 07702
Phone (732) 389-2500

66 W Gilbert St
Ste 200
Tinton Falls, NJ 07701
Phone (732) 212-0051

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266537600000",
    "number": "1063516441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1131 BROAD STREET",
            "address_2": "STE 102",
            "city": "SHREWSBURY",
            "state": "NJ",
            "postal_code": "07702",
            "telephone_number": "732-389-2500",
            "fax_number": "732-389-2820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1131 BROAD STREET",
            "address_2": "STE 102",
            "city": "SHREWSBURY",
            "state": "NJ",
            "postal_code": "07702",
            "telephone_number": "732-389-2500",
            "fax_number": "732-389-2820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAPORITO",
        "first_name": "JOHN",
        "middle_name": "LEWIS",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-07",
        "last_updated": "2010-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NJ",
            "license": "25MA03949800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shrewsbury, NJ

Sources for this page

Verify at the official NPI Registry.