Individual provider Active NPI

Salvatore Dangelo, M D

  • Allergy & Immunology (Internal Medicine) Physician
  • Ridgewood, NJ
National Provider Identifier
1245215664
Registry record updated Dec 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology (Internal Medicine) PhysicianTaxonomy code 207RA0201X
License
25MA02961200 Issued in NJ
Practice address
71 S Maple Ave
Ridgewood, NJ 07450-4509
Phone
(201) 445-4557
Fax
(201) 445-2365
NPI assigned
Dec 8, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MA29612 NJ
Allergy & Immunology (Internal Medicine) Physician 207RA0201X 25MA02961200 NJ Primary

Addresses

Primary practice location

71 S Maple Ave
Ridgewood, NJ 07450-4509

Mailing address

71 S Maple Ave
Ridgewood, NJ 07450-4509
Phone (201) 445-4557

Other identifiers 8

IdentifierTypeStateIssuer
0493902MedicaidNJ
1111081OtherNJHORIZON N.J. FAMILYCARE
1161071OtherNJHORIZON N.J. FAMILYCARE
01078270OtherNJAMERIGROUP
0150142000OtherNJAMERIHEALTH
P3284699OtherNJOXFORD
8328385OtherNJCIGNA
8828709MedicaidNJ

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

LicenseStateTypeSpecialty
MA29612NJMDSpecialist
25MA02961200NJMDAllergy & Immunology (Internal Medicine) Physician

NPI Registry JSON

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

{
    "created_epoch": "1134000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481846400000",
    "number": "1245215664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 S MAPLE AVE",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074504509",
            "telephone_number": "201-445-4557",
            "fax_number": "201-445-2365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 S MAPLE AVE",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074504509",
            "telephone_number": "201-445-4557",
            "fax_number": "201-445-2365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANGELO",
        "first_name": "SALVATORE",
        "name_prefix": "Dr.",
        "credential": "M D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-08",
        "last_updated": "2016-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NJ",
            "license": "MA29612",
            "primary": false
        },
        {
            "code": "207RA0201X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Allergy & Immunology",
            "state": "NJ",
            "license": "25MA02961200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0493902",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON N.J. FAMILYCARE",
            "identifier": "1111081",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON N.J. FAMILYCARE",
            "identifier": "1161071",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "01078270",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "0150142000",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P3284699",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "8328385",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8828709",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2016; 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.