Michael David Delisi, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

25MA05259000 Issued in NJ

Practice address

1135 Broad St
St. Joseph's Family Medicine at Clifton
Clifton, NJ 07013-3346

Phone

(973) 754-4100

NPI assigned

Jun 12, 2006

Last updated

Nov 15, 2012By 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 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• St. Joseph Regional Medical Center

  • General Acute Care Hospital
  • Clifton, NJ
  • NPI 1417254095
  Authorized official Same address or phone
• St. Joseph Regional Medical Center

  • General Acute Care Hospital
  • Clifton, NJ
  • NPI 1881991461
  Authorized official Same address or phone
• St. Joseph's Regional Medical Center

  • Chronic Disease Hospital
  • Clifton, NJ
  • NPI 1598074957
  Authorized official Same address or phone

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352937600000",
    "number": "1275575110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 MAIN ST",
            "address_2": "ST. JOSEPH'S REGIONAL MEDICAL CENTER",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075032621",
            "telephone_number": "973-754-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 BROAD ST",
            "address_2": "ST. JOSEPH'S FAMILY MEDICINE AT CLIFTON",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070133346",
            "telephone_number": "973-754-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELISI",
        "first_name": "MICHAEL",
        "middle_name": "DAVID",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2012-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA05259000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4136403",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1968009",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Harold Dela Pena
• Francis Dela Torre, PT, DPT
• Delacruz&Delacruz Medical Supply
• Heather M Delaney, LCSW, LCADC
• Delia M Ferrer O D P a
• David Delvecchio
• Maria B Delvecchio, MDQ
• Alma Dema, D.M.D.
• Kelly Denega
• Lidia D Dengelegi Abrams, PHD

• Family Medicine Physician in Clifton, NJ
• Providers in Clifton, NJ by specialty
• Family Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 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.