Individual provider Active NPI

Anthony Joseph Prestipino, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Philadelphia, PA
National Provider Identifier
1124032602
Registry record updated Apr 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
MD032946E Issued in PA
Practice address
132 S 10TH St
285K
Philadelphia, PA 19107-5244
Phone
(215) 503-5642
Fax
(215) 503-4817
NPI assigned
Jul 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Pathology/Laboratory Medicine Physician 207ZP0105X MA72994 NJ
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X MD032946E PA Primary

Addresses

Primary practice location

132 S 10TH St
285K
Philadelphia, PA 19107-5244

Mailing address

132 S 10TH St
285K
Philadelphia, PA 19107-5244

Other identifiers 1

IdentifierTypeStateIssuer
8650608MedicaidNJ

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD032946EPAMDAnatomic Pathology & Clinical Pathology Physician
MA72994NJMDClinical Pathology/Laboratory Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rancocas Zurbrugg Pathology Assoc Inc Anatomic Pathology & Clinical Pathology Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427932800000",
    "number": "1124032602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 S 10TH ST",
            "address_2": "285K",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 S 10TH ST",
            "address_2": "285K",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075244",
            "telephone_number": "215-503-5642",
            "fax_number": "215-503-4817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRESTIPINO",
        "first_name": "ANTHONY",
        "middle_name": "JOSEPH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2015-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0105X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": "NJ",
            "license": "MA72994",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "PA",
            "license": "MD032946E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8650608",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2015; 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.