Individual provider Active NPI

Joseph Philip Cassotta, MD

  • Family Medicine Physician
  • Fort Lee, NJ
National Provider Identifier
1093870776
Registry record updated Jul 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
42457 Issued in NJ
Practice address
1600 Center Ave
Fort Lee, NJ 07024-4731
Phone
(201) 585-7511
NPI assigned
Dec 23, 2006
Last updated
Jul 9, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 42457 NJ Primary

Addresses

Primary practice location

1600 Center Ave
Fort Lee, NJ 07024-4731

Mailing address

1600 Center Ave
Fort Lee, NJ 07024-4731
Phone (201) 585-7511

Other identifiers 1

IdentifierTypeStateIssuer
0478903MedicaidNJ

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
I20101021001270 NJ Practitioner - Family Practice 4981676574 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Metrohealth, LLCGroup PAC ID 4688566938, 2 clinicians

Practice addresses (Care Compare)

1600 Ctr Ave
Suite 1
Fort Lee, NJ 07024-4710
Phone (201) 837-7003

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
42457NJMDFamily Medicine Physician

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1166832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278633600000",
    "number": "1093870776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 CENTER AVE",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070244731",
            "telephone_number": "201-585-7511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 CENTER AVE",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070244731",
            "telephone_number": "201-585-7511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASSOTTA",
        "first_name": "JOSEPH",
        "middle_name": "PHILIP",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-23",
        "last_updated": "2010-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "42457",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0478903",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lee, NJ

Sources for this page

Verify at the official NPI Registry.