Michael A Pontoriero, M.D.
Individual provider Active NPI Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician · Clifton, NJ
NPI 1275536765 · NPPES record last updated Apr 26, 2024
Key facts
- NPI
- 1275536765
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X
- License
- 25MA04831400 (NJ)
- Practice address
- 1401 Broad St
Clifton, NJ 07013-4236 - Phone
- (973) 759-9000
- Fax
- (973) 759-3297
- NPI assigned
- May 27, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Vascular Surgery
- Education
- Rutgers New Jersey Medical School, 1985
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Barnabas Health Medical Group, PC
CCG Medical Group LLC
Practice addresses (Care Compare)
201 Lyons Ave
Newark, NJ 07112-2027
Phone (732) 923-7455
433 Central Ave
Westfield, NJ 07090-2520
Phone (973) 759-9000
788 Broad St
Shrewsbury, NJ 07702-4203
Phone (973) 759-9000
Hospital & facility affiliations
- Clara Maass Medical Center
- Hackensack Meridian Mountainside Medical
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Varicose vein removal | 1-10 |
| Leg revascularization (restoring blood flow) | 1-10 |
| Removal of tissue | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050816000100 | NJ | Practitioner - Vascular Surgery |
0244260701 | Reassigns benefits to 5 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MAO4831400 | NJ | MD | Specialist |
| 25MA04831400 | NJ | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Barnabas Health Medical Group, PC | Specialist | Current |
Accepting new patients |
| CCG Medical Group LLC | Specialist | Current |
Accepting new patients |
| Barnabas Health Medical Group PC | Specialist | Current |
Accepting new patients |
| Cardiovascular Care Group PC | Specialist | Current |
Accepting new patients |
| Barnabas Health Medical Group PC | Current |
Accepting new patients | |
| CCG Medical Group LLC | Specialist | Current |
Accepting new patients |
Locations
5 Franklin Ave
Ste 504
Belleville, NJ 07109
1401 Broad St
Ste 1
Clifton, NJ 07013
1401 Broad St
Clifton, NJ 07013
3155 State Route 10
Ste 100
Denville, NJ 07834
Phone (973) 927-5788
129 Washington St
Fl 4
Hoboken, NJ 07030
475 Route 70
Ste 101
Lakewood, NJ 08701
Phone (732) 364-8000
94 Old Short Hills Rd
Livingston, NJ 07039
Phone (973) 322-5400
100 Madison Ave
Morristown, NJ 07960
Phone (973) 538-5210
95 Madison Ave
Ste 109
Morristown, NJ 07960
Phone (973) 538-8336
201 Lyons Ave
#L4
Newark, NJ 07112
Phone (973) 926-7154
201 Lyons Ave
Newark, NJ 07112
Phone (732) 923-7455
201 Lyons Ave
Fl D4
Newark, NJ 07112
Phone (973) 926-2973
788 Broad St
Shrewsbury, NJ 07702
788 Broad St
#1
Shrewsbury, NJ 07702
379 Campus Dr
Fl 4
Somerset, NJ 08873
Phone (732) 507-6545
649 Morris Ave
Springfield, NJ 07081
Phone (973) 795-7955
673 Morris Ave
Ste 201
Springfield, NJ 07081
Phone (212) 241-2087
266 King George Rd
Warren, NJ 07059
Phone (732) 667-7778
223 Monmouth Rd
West Long Branch, NJ 07764
Phone (732) 229-3838
433 Central Ave
Westfield, NJ 07090
433 Central Ave
Fl 2
Westfield, NJ 07090
Phone (973) 302-8700
Interoperability endpoints
- mpontoriero@direct.rwjbh.org
- mpontoriero@tcvcg.ssdirect.aprima.com
- mpontoriero208172@ahs.direct-ci.com
- mpontoriero102576@epicdirect.rwjbh.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 25MAO4831400 | NJ | |
| Surgery Physician | 208600000X | 25MA04831400 | NJ | |
| Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 208G00000X | 25MA04831400 | NJ | Yes |
Addresses
Primary practice location
1401 Broad St
Clifton, NJ 07013-4236
Mailing address
433 Central Ave
Westfield, NJ 07090-2520
Phone (973) 759-9000
Other providers in Clifton, NJ
- Enrique Polo Molina
- Katherine Delaney Polos
- Shira Pomrantz
- Justin Charles Ponquinette
- Maria Lauren Pontoriero
- Cornelio Porras
- Joseph Porter
- Jonathan Portorreal
- Justyna Potocka
- Power of One Christian Coaching and Outreach Ministries, Inc
All providers in Clifton, NJ · Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 26, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.