Individual provider Active NPI

Ricardo Caraballo, MD

  • Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
  • Voorhees, NJ
National Provider Identifier
1275639783
Registry record updated Jul 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) PhysicianTaxonomy code 207VF0040X
License
NJMA63196 Issued in NJ
Practice address
6012 Main Street
Voorhees, NJ 08043
Phone
(856) 325-6622
Fax
(856) 325-6522
NPI assigned
Sep 15, 2006
Last updated
Jul 25, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 25MA06319600 NJ
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician 207VF0040X NJMA63196 NJ Primary

Addresses

Primary practice location

6012 Main Street
Voorhees, NJ 08043

Mailing address

PO Box 416457
Boston, MA 02241-6457
Phone (973) 656-6280

Other identifiers 10

IdentifierTypeStateIssuer
1105869OtherNJHORIZON NJ HEALTH
010003742OtherNJAMERICHOICE
9402184OtherNJCIGNA
3K7732OtherNJHEALTHNET
P2704813OtherNJOXFORD
0094687000OtherNJAMERIHEALTH/KEYSTONE/IBC
1949172OtherNJUNITED HEALTHCARE
24212OtherNJUNIVERSITY HEALTH PLAN
7780702MedicaidNJ
2207042/7597015OtherNJAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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 1

Enrollment IDStateProvider typePAC IDDetails
I20040824000383 NJ Practitioner - Obstetrics/Gynecology 0648244863 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Temple University School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Practice Associates Medical GroupGroup PAC ID 5890703177, 1,412 clinicians

Practice addresses (Care Compare)

435 S St
Suite 370
Morristown, NJ 07960-6440
Phone (973) 971-7440

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of the uterus1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA06319600NJMDObstetrics & Gynecology Physician
NJMA63196NJMDFemale Pelvic Medicine and Reconstructive Surgery (Obstetrics & Gynecology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cooper Obstetrical Associates, PC Obstetrics & Gynecology CurrentSince Aug 30, 2016 Accepting new patients
University Urogynecology Association, PC Obstetrics & Gynecology CurrentSince Nov 20, 2007 Accepting new patients
Practice Associates Medical Group Obstetrics & Gynecology CurrentSince Oct 10, 2016 Accepting new patients
Cooper Surgical Associates, PA PastSince Nov 20, 2007 Accepting new patients
Atlanticare Regional Medical Center Past Accepting new patients

Locations

1 Federal St
Ste SW200
Camden, NJ 08103
Phone (856) 356-4920

3 Cooper Plz
Rm 301
Camden, NJ 08103
Phone (856) 342-2959

100 Madison Ave
Morristown, NJ 07960
Phone (973) 538-5210

435 South St
Ste 370
Morristown, NJ 07960
Phone (973) 971-7267

6012 Main St
Voorhees, NJ 08043
Phone (856) 325-6622

Organizations & group practices 5

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469404800000",
    "number": "1275639783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 416457",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022416457",
            "telephone_number": "973-656-6280",
            "fax_number": "973-290-7495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6012 MAIN STREET",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "08043",
            "telephone_number": "856-325-6622",
            "fax_number": "856-325-6522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARABALLO",
        "first_name": "RICARDO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2016-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NJ",
            "license": "25MA06319600",
            "primary": false
        },
        {
            "code": "207VF0040X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery",
            "state": "NJ",
            "license": "NJMA63196",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON NJ HEALTH",
            "identifier": "1105869",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICHOICE",
            "identifier": "010003742",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "9402184",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "3K7732",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P2704813",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH/KEYSTONE/IBC",
            "identifier": "0094687000",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1949172",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERSITY HEALTH PLAN",
            "identifier": "24212",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7780702",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2207042/7597015",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Voorhees, NJ

Sources for this page

Verify at the official NPI Registry.