Individual provider Active NPI

Anthony Infantolino, M.D.

  • Gastroenterology Physician
  • Mount Laurel, NJ
National Provider Identifier
1164481032
Registry record updated May 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
25MA06588100 Issued in NJ
Practice address
501 Fellowship Rd Ste 101
Mount Laurel, NJ 08054-3419
Phone
(856) 642-2133
NPI assigned
Mar 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 25MA06588100 NJ Primary

Addresses

Primary practice location

501 Fellowship Rd Ste 101
Mount Laurel, NJ 08054-3419

Mailing address

1 Federal St Ste 200
Camden, NJ 08103-1088
Phone (848) 288-6935

Other identifiers 1

IdentifierTypeStateIssuer
0012103610004MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20070430000503 PA Practitioner - Gastroenterology 8921104449 Reassigns benefits to 1 organization
I20190903000296 NJ Practitioner - Gastroenterology 8921104449 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Rutgers R W Johnson Medical School (Cam/New Bruns/Pisc), 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

501 Fellowship Rd
Suite 101
Mount Laurel, NJ 08054-3419
Phone (856) 642-2133

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy106
Upper gastrointestinal (GI) endoscopy for acid reflux240

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA06588100NJMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
CMC Department of Medicine Group PA CurrentSince Jun 1, 2023 Accepting new patients
Jefferson University Physicians CurrentSince Aug 1, 2015 Accepting new patients

Locations

3 Cooper Plz
Rm 311
Camden, NJ 08103
Phone (856) 342-2034

3 Cooper Plz
Rm 215
Camden, NJ 08103
Phone (856) 342-2439

1 Federal St
Ste 200
Camden, NJ 08103
Phone (848) 288-6935

2 Stone Harbor Blvd
Cape May Court House, NJ 08210
Phone (609) 463-2000

215 N Main St
Cape May Court House, NJ 08210
Phone (609) 463-2273

400 W Route 38
Moorestown, NJ 08057
Phone (856) 270-4000

501 Fellowship Rd
Mount Laurel, NJ 08054

501 Fellowship Rd
Ste 101
Mount Laurel, NJ 08054
Phone (856) 963-3572

443 Laurel Oak Rd
Ste 130
Voorhees, NJ 08043
Phone (856) 741-0122

132 S 10th St
Ste 480
Philadelphia, PA 19107
Phone (215) 955-1132

132 S 10th St
#480
Philadelphia, PA 19107
Phone (215) 955-3947

925 Chestnut St
Fl 6
Philadelphia, PA 19107
Phone (215) 955-6760

132 S 10th St
Fl 4
Philadelphia, PA 19107

Interoperability endpoints

  • Direct secure messaging: ainfantolino166876@direct.cooperhealth.edu

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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": "1142812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715212800000",
    "number": "1164481032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FEDERAL ST STE 200",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031088",
            "telephone_number": "848-288-6935",
            "fax_number": "732-790-0107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 FELLOWSHIP RD STE 101",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080543419",
            "telephone_number": "856-642-2133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INFANTOLINO",
        "first_name": "ANTHONY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-20",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NJ",
            "license": "25MA06588100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0012103610004",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Laurel, NJ

Sources for this page

Verify at the official NPI Registry.