Dominick Anthony Siconolfi III, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

25MB11059000 Issued in NJ

Practice address

18 E Laurel Rd
Stratford, NJ 08084-1327

Phone

(856) 346-7985

NPI assigned

Jun 4, 2018

Last updated

Oct 2, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ, IA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Emergency Medicine

Education

Rowan University School of Osteopathic Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Emergency Physician Associates of North Jersey P CGroup PAC ID 7911992326, 125 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Riverview Medical Center Hospital, Red Bank, NJ, CCN 310034

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Emergency Physician Associates of North Jersey P C

  • Emergency Medicine Physician
  • Summit, NJ
  • NPI 1497783419
  Medicare reassignment Care Compare group NPD
• Capital Health Multispecialty Group

  • Surgery Physician
  • Trenton, NJ
  • NPI 1083072342

  Emergency Medicine

  Medicare reassignment NPD
• Emergency Physician Associates of South Jersey P C

  • Emergency Medicine Physician
  • Voorhees, NJ
  • NPI 1215965231
  Medicare reassignment NPD
• Winneshiek Medical Center

  dba WinnMed

  • Critical Access Hospital
  • Decorah, IA
  • NPI 1619922051
  Medicare reassignment NPD
• Atlantic Professional Services of New Jersey, P.a.

  • Physician Assistant
  • Stratford, NJ
  • NPI 1932145182
  NPD (past)

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

• HMH Hospitals Corporation

  dba Hackensack Meridian Diagnostic Laboratory

  • Clinical Medical Laboratory
  • Red Bank, NJ
  • NPI 1295452886

  Hospital

  Care Compare affiliation
• HMH Hospitals Corporation

  dba Riverview Medical Center

  • General Acute Care Hospital
  • Red Bank, NJ
  • NPI 1710499462
  Care Compare affiliation

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

{
    "created_epoch": "1528070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727827200000",
    "number": "1255823415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 E LAUREL RD",
            "city": "STRATFORD",
            "state": "NJ",
            "postal_code": "080841327",
            "telephone_number": "856-346-7985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 E LAUREL RD",
            "city": "STRATFORD",
            "state": "NJ",
            "postal_code": "080841327",
            "telephone_number": "856-346-7985"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 1st Dr NW",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "MN",
            "postal_code": "559122941",
            "country_code": "US",
            "telephone_number": "507-433-7351",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SICONOLFI",
        "first_name": "DOMINICK",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-04",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MN",
            "license": "72901",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "25MB11059000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mina Shenouda
• Sanath S Shetty, DO
• Dong Wook Shin, DO
• Haejung Katelyn Shin, DO
• Victoria Shwe
• Ali Mairaj Siddiqui, D.O.
• Safia Anwar Pasha Siddiqui, M.D
• Robert M. Sidwa, DO
• Rachel Isabel Silliman Cohen, MD
• Thomas Sim, DO

• Emergency Medicine Physician in Stratford, NJ
• Providers in Stratford, NJ by specialty
• Emergency Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.