Individual provider Active NPI

Michael Caruso, L.P.N.

  • Licensed Practical Nurse
  • Galloway, NJ
National Provider Identifier
1124423322
Registry record updated Oct 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
26NP06118600 Issued in NJ
Practice address
421 Dennis Dr
Galloway, NJ 08205-9630
Phone
(609) 652-3691
Fax
(609) 652-3691
NPI assigned
Oct 30, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 30, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 26NP06118600 NJ Primary

Addresses

Primary practice location

421 Dennis Dr
Galloway, NJ 08205-9630

Mailing address

421 Dennis Dr
Galloway, NJ 08205-9630
Phone (609) 652-3691

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
26NP06118600NJMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1414627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414627200000",
    "number": "1124423322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 DENNIS DR",
            "city": "GALLOWAY",
            "state": "NJ",
            "postal_code": "082059630",
            "telephone_number": "609-652-3691",
            "fax_number": "609-652-3691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 DENNIS DR",
            "city": "GALLOWAY",
            "state": "NJ",
            "postal_code": "082059630",
            "telephone_number": "609-652-3691",
            "fax_number": "609-652-3691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARUSO",
        "first_name": "MICHAEL",
        "credential": "L.P.N.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-10-30",
        "last_updated": "2014-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NJ",
            "license": "26NP06118600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Galloway, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2014; 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.