Individual provider Active NPI

Diego Saporta, M.D.

  • Otolaryngic Allergy Physician
  • Elizabeth, NJ
National Provider Identifier
1164423299
Registry record updated Jun 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngic Allergy PhysicianTaxonomy code 207YX0602X
License
25MA05512700 Issued in NJ
Practice address
470 North Ave
Elizabeth, NJ 07208-1738
Phone
(908) 352-6700
Fax
(908) 352-6734
NPI assigned
Aug 10, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngic Allergy Physician 207YX0602X 25MA05512700 NJ Primary
Otolaryngic Allergy Physician 207YX0602X 177474-1 NY

Addresses

Primary practice location

470 North Ave
Elizabeth, NJ 07208-1738

Mailing address

470 North Ave
Elizabeth, NJ 07208-1738
Phone (908) 352-6700

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
I20231222001520 NJ Order and Referring Only - OtolaryngologyPractitioner - Otolaryngology 1557357670

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
177474-1NYMDOtolaryngic Allergy Physician

NPI Registry JSON

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

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338768000000",
    "number": "1164423299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "470 NORTH AVE",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072081738",
            "telephone_number": "908-352-6700",
            "fax_number": "908-352-6734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "470 NORTH AVE",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072081738",
            "telephone_number": "908-352-6700",
            "fax_number": "908-352-6734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAPORTA",
        "first_name": "DIEGO",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2012-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0602X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngic Allergy",
            "state": "NJ",
            "license": "25MA05512700",
            "primary": true
        },
        {
            "code": "207YX0602X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngic Allergy",
            "state": "NY",
            "license": "177474-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabeth, NJ

Sources for this page

Verify at the official NPI Registry.