Active NPI
Richard W Dicicco, D.C.
- Chiropractor
- Cedar Brook, NJ
National Provider Identifier
1073668265
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 38MC00418400
- Practice address
- 1 Myers Avenue
Cedar Brook, NJ 08018 - Phone
- (609) 561-1150
- NPI assigned
- Jan 25, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 38MC00418400 | NJ | Primary |
Addresses
Primary practice location
1 Myers Avenue
Cedar Brook, NJ 08018
Mailing address
P.O. Box 308
1 Myers Ave
Cedar Brook, NJ 08018
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0673372000 | Other | NJ | AMERIHEALTH |
| 2230846 | Other | NJ | AETNA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Chiropractor
- Berlin, NJ
- NPI 1598898017
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169683200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1073668265",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 308",
"address_2": "1 MYERS AVE",
"city": "CEDAR BROOK",
"state": "NJ",
"postal_code": "08018"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 MYERS AVENUE",
"city": "CEDAR BROOK",
"state": "NJ",
"postal_code": "08018",
"telephone_number": "609-561-1150"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DICICCO",
"first_name": "RICHARD",
"middle_name": "W",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NJ",
"license": "38MC00418400",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIHEALTH",
"identifier": "0673372000",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "2230846",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cedar Brook, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.