J C Digiacomo, MD., LLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

25MA05397100 Issued in NM

Legal business name

J C DIGIACOMO, MD., LLC

Practice address

900 W Main St
Suite 4
Freehold, NJ 07728-2523

Phone

(732) 303-9584

Fax

(732) 294-1940

NPI assigned

May 1, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Jody C Digiacomo, MD

Title

Surgeon

Phone

(732) 683-0888

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212710400000",
    "number": "1104047901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 W MAIN ST",
            "address_2": "SUITE 4",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077282523",
            "telephone_number": "732-303-9584",
            "fax_number": "732-294-1940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 W MAIN ST",
            "address_2": "SUITE 4",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077282523",
            "telephone_number": "732-303-9584",
            "fax_number": "732-294-1940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J C DIGIACOMO, MD., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-01",
        "last_updated": "2008-06-06",
        "status": "A",
        "authorized_official_last_name": "DIGIACOMO",
        "authorized_official_first_name": "JODY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "SURGEON",
        "authorized_official_telephone_number": "732-683-0888",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NM",
            "license": "25MA05397100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5164001",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Freehold, NJ
• Providers in Freehold, NJ by specialty
• Specialist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 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.