NPIMap

Individual provider Active NPI

Anthony Detulio, M.D.

  • Internal Medicine Physician
  • Holmdel, NJ
National Provider Identifier
1205806064
Registry record updated Jun 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MA55002 Issued in NJ
Practice address
733 N Beers St
Suite 3
Holmdel, NJ 07733-1528
Phone
(732) 264-8484
Fax
(732) 264-4324
NPI assigned
Jan 25, 2006
Last updated
Jun 2, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MA55002 NJ Primary

Addresses

Primary practice location

733 N Beers St
Suite 3
Holmdel, NJ 07733-1528

Mailing address

733 N Beers St
Suite 3
Holmdel, NJ 07733-1528
Phone (732) 264-8484

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050622000731 NJ Practitioner - Internal Medicine 4486699261 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hackensack Meridian Health Medical Group - Primary Care PCGroup PAC ID 7911003330, 364 clinicians

Practice addresses (Care Compare)

985 Cedar Bridge Ave
Brick, NJ 08723-4167
Phone (732) 477-5600

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.09 of 100Reported as apm
Quality
86.89
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA55002NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hackensack Meridian Health Medical Group - Primary Care PC Internal Medicine CurrentSince Jan 1, 2014 Accepting new patients
Jersey Shore Medical Associates PC Internal Medicine Past Accepting new patients

Locations

985 Cedar Bridge Ave
Brick, NJ 08723
Phone (732) 477-5600

733 N Beers St
Ste 3
Holmdel, NJ 07733
Phone (732) 264-8484

735 N Beers St
Fl 2
Holmdel, NJ 07733
Phone (732) 264-8484

Interoperability endpoints

  • Direct secure messaging: anthony.detulio@direct.hackensackmeridian.org
  • FHIR API: https://mepic.hmhn.org/fhir/api/FHIR/R4/

Organizations & group practices 2

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.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464825600000",
    "number": "1205806064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "733 N BEERS ST",
            "address_2": "SUITE 3",
            "city": "HOLMDEL",
            "state": "NJ",
            "postal_code": "077331528",
            "telephone_number": "732-264-8484",
            "fax_number": "732-264-4324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "733 N BEERS ST",
            "address_2": "SUITE 3",
            "city": "HOLMDEL",
            "state": "NJ",
            "postal_code": "077331528",
            "telephone_number": "732-264-8484",
            "fax_number": "732-264-4324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETULIO",
        "first_name": "ANTHONY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-25",
        "last_updated": "2016-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "MA55002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holmdel, NJ

Sources for this page

Verify at the official NPI Registry.