NPIMap

Organization Active NPI

Rutgers University Dental Associates-New Brunswick

  • Dentist
  • New Brunswick, NJ
National Provider Identifier
1164874376
Registry record updated May 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
22DI02319600 Issued in NJ
Legal business name
RUTGERS UNIVERSITY DENTAL ASSOCIATES-NEW BRUNSWICK
Practice address
135 Somerset Street
Suite a
New Brunswick, NJ 08901-2072
Phone
(732) 235-5050
Fax
(732) 220-0045
NPI assigned
Jul 12, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2024

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

Authorized official

Name
Rosemarie O Vaccaro
Title
Sr MGR Billing & Collections Office
Phone
(973) 972-8664

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 22DI02319600 NJ Primary

Addresses

Primary practice location

135 Somerset Street
Suite a
New Brunswick, NJ 08901-2072

Mailing address

135 Somerset Street
Suite a
New Brunswick, NJ 08901-2072
Phone (732) 235-5050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161027000915 NJ Part B Supplier - Clinic/Group Practice 4385922251 Receives reassigned benefits from 9 practitioners
Practice locations: New Brunswick, NJ

National Provider Directory

National Provider Directory
Tax ID family
Rutgers School of Dental Medicine2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

135 Somerset St
Ste A
New Brunswick, NJ 08901
Phone (732) 235-5050

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1468281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716163200000",
    "number": "1164874376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 SOMERSET STREET",
            "address_2": "SUITE A",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089012072",
            "telephone_number": "732-235-5050",
            "fax_number": "732-220-0045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 SOMERSET STREET",
            "address_2": "SUITE A",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089012072",
            "telephone_number": "732-235-5050",
            "fax_number": "732-220-0045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUTGERS UNIVERSITY DENTAL ASSOCIATES-NEW BRUNSWICK",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-12",
        "last_updated": "2024-05-20",
        "status": "A",
        "authorized_official_last_name": "VACCARO",
        "authorized_official_first_name": "ROSEMARIE",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "SR MGR BILLING & COLLECTIONS OFFICE",
        "authorized_official_telephone_number": "973-972-8664"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI02319600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Brunswick, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.