Active NPI
Melissa Maria Sotillo, MD
- Specialist
- Sparta, NJ
National Provider Identifier
1184613077
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- MA07760500
- Practice address
- 147 Woodport Rd
Sparta, NJ 07871-2339 - Phone
- (973) 726-0801
- Fax
- (973) 726-0802
- NPI assigned
- Oct 14, 2005
- Last updated
- Nov 14, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | MA07760500 | NJ | Primary |
Addresses
Primary practice location
147 Woodport Rd
Sparta, NJ 07871-2339
Mailing address
147 Woodport Rd
Sparta, NJ 07871-2339
Phone (973) 726-0801
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0051144 | Medicaid | NJ |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA07760500 | NJ | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Northwest New Jersey Medical-Surgical Alliance P C | Past | Accepting new patients |
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.
-
- Orthopaedic Surgery Physician
- Newton, NJ
- NPI 1184807604
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129248000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1352851200000",
"number": "1184613077",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "147 WOODPORT RD",
"city": "SPARTA",
"state": "NJ",
"postal_code": "078712339",
"telephone_number": "973-726-0801",
"fax_number": "973-726-0802"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "147 WOODPORT RD",
"city": "SPARTA",
"state": "NJ",
"postal_code": "078712339",
"telephone_number": "973-726-0801",
"fax_number": "973-726-0802"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOTILLO",
"first_name": "MELISSA",
"middle_name": "MARIA",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-10-14",
"last_updated": "2012-11-14",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NJ",
"license": "MA07760500",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0051144",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sparta, NJ
- Elisheva Slomiuc
- Jeanne Smetana, M.S.W., L..C.S.W.
- Anissa Leeann Smith, FNP-BC
- Katelyn Smith, LPC
- Sos Wellness and Organics, LLC
- SP Eyecare of Sparta (Pearle Vision Of Sparta)
- Sparta Ambulance Service Inc
- Sparta Anesthesia Associates, LLC
- Sparta Cancer Center LLC
- Sparta Chiropractic and Wellness Center, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.