Michael Dominick Cibelli, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

174 Edison Rd
Lake Hopatcong, NJ 07849-2217

Phone

(973) 663-2700

NPI assigned

Oct 18, 2021

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

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Networks

• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H5989

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Samaritan Medical Services, P.C.

  • Internal Medicine Physician
  • West Islip, NY
  • NPI 1124184544
  Medicare reassignment

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

{
    "created_epoch": "1634515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634515200000",
    "number": "1285397182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 PRICE CT",
            "city": "DENVILLE",
            "state": "NJ",
            "postal_code": "078342176",
            "telephone_number": "610-295-4473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "174 EDISON RD",
            "city": "LAKE HOPATCONG",
            "state": "NJ",
            "postal_code": "078492217",
            "telephone_number": "973-663-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIBELLI",
        "first_name": "MICHAEL",
        "middle_name": "DOMINICK",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-18",
        "last_updated": "2021-10-18",
        "certification_date": "2021-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jean-Paul Bonnet, D.O.
• Kyle Henry Brockmann, LMT
• Cadc Pharmacy Inc
• Patrick F Carillo, RPH
• Constantine Christodoulou, LCSW
• Diana M Cipullo, PT, DPT
• Shaun Marie Colavita
• Lois Crispino
• Sara Jean Currenti, M.S., BCBA
• Walter Clayton Davis, MA, LPC

• Physician Assistant in Lake Hopatcong, NJ
• Providers in Lake Hopatcong, NJ by specialty
• Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.