Michelle L. Iacaruso, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

25MB08365400 Issued in NJ

Practice address

39 Olcott SQ
Bernardsville, NJ 07924-2317

Phone

(908) 221-1919

Fax

(908) 221-1005

NPI assigned

Mar 21, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• Geisinger Clinic

  • Family Medicine Physician
  • Pottsville, PA
  • NPI 1043261183
  NPD (past)
• Geisinger Clinic

  • Diagnostic Radiology Physician
  • Danville, PA
  • NPI 1558313023
  NPD (past)

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

{
    "created_epoch": "1142899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205884800000",
    "number": "1083673784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 OLCOTT SQ",
            "city": "BERNARDSVILLE",
            "state": "NJ",
            "postal_code": "079242317",
            "telephone_number": "908-221-1919",
            "fax_number": "908-221-1005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 OLCOTT SQ",
            "city": "BERNARDSVILLE",
            "state": "NJ",
            "postal_code": "079242317",
            "telephone_number": "908-221-1919",
            "fax_number": "908-221-1005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IACARUSO",
        "first_name": "MICHELLE",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-21",
        "last_updated": "2008-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MB08365400",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS009282L",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Healing Physical Therapy
• Hellertek LLC
• Christina Hoffman, LPC
• Chelsea Holler, LPC
• Raymond Horman, DC
• Noorulain Imtiaz
• Integrated Behavioral Care PA
• J&C Physiotherapy
• Nell T Jackson, M.A., L.P.C.
• Jane M Webber PHD LPC Counseling & Psychotherapy

• Family Medicine Physician in Bernardsville, NJ
• Providers in Bernardsville, NJ by specialty
• Family Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2008; 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.