Jeffrey Petrozzino, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

25MA09417600 Issued in NJ

Practice address

646 Kings Hwy
West Deptford, NJ 08096

Phone

(856) 879-2887

Fax

(856) 879-2855

NPI assigned

Jan 29, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 6

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Advocare , LLC

  • Internal Medicine Physician
  • Manahawkin, NJ
  • NPI 1912762162
  NPD
• Advocare, LLC

  • Pediatrics Physician
  • Marlton, NJ
  • NPI 1770538696
  NPD
• Nemours New Jersey Physician Practice, P.C.

  • Pediatrics Physician
  • Deptford, NJ
  • NPI 1265874713
  NPD
• PM Pediatrics of Bayside PLLC

  • Urgent Care Clinic/Center
  • Nanuet, NY
  • NPI 1861823197
  NPD (past)
• PM Pediatrics of Mamaroneck

  • Urgent Care Clinic/Center
  • Mamaroneck, NY
  • NPI 1073645180
  NPD (past)
• PM Pediatrics PC

  • Urgent Care Clinic/Center
  • Syosset, NY
  • NPI 1730212390

  Pediatrics

  NPD (past)
• SCHC Pediatric Associates, LLC

  • Pediatrics Physician
  • Philadelphia, PA
  • NPI 1255363578
  NPD (past)

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

{
    "created_epoch": "1233187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539734400000",
    "number": "1083852958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "646 KINGS HWY",
            "city": "WEST DEPTFORD",
            "state": "NJ",
            "postal_code": "080963145",
            "telephone_number": "856-879-2887",
            "fax_number": "856-879-2855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "646 KINGS HWY",
            "city": "WEST DEPTFORD",
            "state": "NJ",
            "postal_code": "08096",
            "telephone_number": "856-879-2887",
            "fax_number": "856-879-2855"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "509 N Broad St",
            "address_purpose": "LOCATION",
            "city": "Woodbury",
            "state": "NJ",
            "postal_code": "080961617",
            "country_code": "US",
            "telephone_number": "856-845-0100",
            "fax_number": "302-651-4945",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "509 N Broad St",
            "address_purpose": "LOCATION",
            "city": "Woodbury",
            "state": "NJ",
            "postal_code": "080961617",
            "country_code": "US",
            "telephone_number": "856-845-0100",
            "fax_number": "302-651-4945",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETROZZINO",
        "first_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-01-29",
        "last_updated": "2018-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "FP4314477",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "CA",
            "license": "A90372",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "NY",
            "license": "233095",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "NJ",
            "license": "FP4314477",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "NJ",
            "license": "25MA09417600",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA09417600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Robert Panchella, M.S, ATC
• Darshan V Patel
• Krupa Patel
• Dylan A. Penna-Powell, MA
• Gabriel Perez, DMD
• Premier Brain and Spine, LLC
• Premier Orthopaedic & Sports Medicine Assoc of Southern NJ LLC
• Premiere Dental NJ Associates PC
• Premiere Dental of West Deptford
• Pro Chiropractic LLC

• Pediatrics Physician in West Deptford, NJ
• Providers in West Deptford, NJ by specialty
• Pediatrics Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.