Individual provider Active NPI

Joseph Colletti, P.A.

  • Medical Physician Assistant
  • Linwood, NJ
National Provider Identifier
1174946479
Registry record updated Jun 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
25MP00326600 Issued in NJ
Practice address
2106 New Rd Ste D4
Linwood, NJ 08221-1050
Phone
(609) 926-6474
Fax
(609) 926-6474
NPI assigned
Jan 23, 2014
Last updated
Jun 29, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 25MP00326600 NJ Primary

Addresses

Primary practice location

2106 New Rd Ste D4
Linwood, NJ 08221-1050

Mailing address

2099 New Albany Rd
Cinnaminson, NJ 08077-3534
Phone (609) 926-8899

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140411001450 NJ Practitioner - Physician Assistant 5890927511 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coyle S Connolly DO PAGroup PAC ID 2961498118, 32 clinicians

Practice addresses (Care Compare)

175 Gunning River Rd E
Barnegat, NJ 08005-1436
Phone (609) 926-8899

2101 Hwy 34 S
Suite H
Wall, NJ 07719-4406
Phone (609) 926-8899

2106 New Rd
Linwood, NJ 08221-1050
Phone (609) 926-8899

Merit-based Incentive Payment System (MIPS)

Final score
93.23 of 100Reported as group
Quality
95.33
Promoting interoperability
86
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
25MP00326600NJMDMedical Physician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1390435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687996800000",
    "number": "1174946479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2099 NEW ALBANY RD",
            "city": "CINNAMINSON",
            "state": "NJ",
            "postal_code": "080773534",
            "telephone_number": "609-926-8899",
            "fax_number": "856-772-1997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2106 NEW RD STE D4",
            "city": "LINWOOD",
            "state": "NJ",
            "postal_code": "082211050",
            "telephone_number": "609-926-6474",
            "fax_number": "609-926-6474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLETTI",
        "first_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-01-23",
        "last_updated": "2023-06-29",
        "certification_date": "2023-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NJ",
            "license": "25MP00326600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Linwood, NJ

Sources for this page

Verify at the official NPI Registry.