Active NPI
Michael Coletta, M.D.
- Emergency Medicine Physician
- Myrtle Beach, SC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 25MA11137100
- Practice address
- 809 82ND Pkwy
Myrtle Beach, SC 29572 - Phone
- (843) 692-1000
- NPI assigned
- Jan 17, 2017
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 82076 | SC | |
| Emergency Medicine Physician | 207P00000X | 25MA11137100 | NJ | Primary |
Addresses
Primary practice location
809 82ND Pkwy
Myrtle Beach, SC 29572
Mailing address
701 N Clayton St
Wilmington, DE 19805-3155
Phone (302) 421-4100
Other practice location 1
1 Cooper Plz
Camden, NJ 08103-1461
Phone (856) 342-2000
Other practice location 2
1 Cooper Plz
Camden, NJ 08103-1461
Phone (856) 342-2000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC, DE, NJ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 3
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- Cooper Medical School of Rowan University, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
509 N Broad St
Woodbury, NJ 08096-1617
Phone (856) 853-2001
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Emergency Physician Associates of Delaware PC | Single Specialty | Current | Accepting new patients |
| Emergency Care Services of New Jersey, PA | Single Specialty | Current | Accepting new patients |
| Prohealth Urgent Care Medicine of New Jersey LLP | Single Specialty | Current | Accepting new patients |
| Acs Primary Care Physicians - Southeast PC | Single Specialty | Current | Accepting new patients |
Locations
701 N Clayton St
Wilmington, DE 19805
Phone (302) 421-4100
1210 Route 130 N
Ste 1438
Cinnaminson, NJ 08077
Phone (551) 313-0170
700 Mullica Hill Rd
Mullica Hill, NJ 08062
Phone (856) 508-1000
1 Harmon Plz
Ste 1010
Secaucus, NJ 07094
509 N Broad St
Woodbury, NJ 08096
Phone (856) 686-5396
809 82nd Pkwy
Myrtle Beach, SC 29572
Phone (843) 291-7182
Organizations & group practices 4
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.
-
- Emergency Medicine Physician
- Woodbury, NJ
- NPI 1992972830
Single Specialty
-
- Emergency Medicine Physician
- Myrtle Beach, SC
- NPI 1861430555
Single Specialty
-
- Emergency Medicine Physician
- Wilmington, DE
- NPI 1679514467
Single Specialty
-
- Emergency Care Clinic/Center
- Edgewater, NJ
- NPI 1477927754
Single Specialty
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Vineland, NJ
- NPI 1164487542
-
- General Acute Care Hospital
- Elmer, NJ
- NPI 1255396024
-
- General Acute Care Hospital
- Mullica Hill, NJ
- NPI 1366097032
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1484611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1673913600000",
"number": "1073059911",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "701 N CLAYTON ST",
"city": "WILMINGTON",
"state": "DE",
"postal_code": "198053155",
"telephone_number": "302-421-4100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "809 82ND PKWY",
"city": "MYRTLE BEACH",
"state": "SC",
"postal_code": "29572",
"telephone_number": "843-692-1000"
}
],
"practiceLocations": [
{
"address_1": "1 Cooper Plz",
"address_purpose": "LOCATION",
"city": "Camden",
"state": "NJ",
"postal_code": "081031461",
"country_code": "US",
"telephone_number": "856-342-2000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1 Cooper Plz",
"address_purpose": "LOCATION",
"city": "Camden",
"state": "NJ",
"postal_code": "081031461",
"country_code": "US",
"telephone_number": "856-342-2000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "COLETTA",
"first_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-01-17",
"last_updated": "2023-01-17",
"certification_date": "2021-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Emergency Medicine",
"state": "SC",
"license": "82076",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "NJ",
"license": "25MA11137100",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Myrtle Beach, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2023; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.