NPIMap

Individual provider Active NPI

Roger J Nocerini, DDS

  • General Practice Dentistry
  • Scranton, PA
National Provider Identifier
1205948411
Registry record updated Nov 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS017448L Issued in PA
Practice address
2611 Pittston Ave
Scranton, PA 18505
Phone
(570) 347-2046
Fax
(570) 346-6527
NPI assigned
Sep 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DS017448L PA Primary

Addresses

Primary practice location

2611 Pittston Ave
Scranton, PA 18505

Mailing address

2611 Pittston Ave
Scranton, PA 18505
Phone (570) 347-2046

Other identifiers 1

IdentifierTypeStateIssuer
1027374300001MedicaidPA

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DS017448LPAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Richard a. Brazon DDS 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352073600000",
    "number": "1205948411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2611 PITTSTON AVE",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "18505",
            "telephone_number": "570-347-2046",
            "fax_number": "570-346-6527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2611 PITTSTON AVE",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "18505",
            "telephone_number": "570-347-2046",
            "fax_number": "570-346-6527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOCERINI",
        "first_name": "ROGER",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-01",
        "last_updated": "2012-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS017448L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1027374300001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scranton, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 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.

Verify at the official NPI Registry.