NPIMap

Organization Active NPI

Carlos a Tello, MD PA

  • General Practice Physician
  • Paterson, NJ
National Provider Identifier
1285765719
Registry record updated Nov 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
25MA04703100 Issued in NJ
Legal business name
CARLOS A TELLO, MD PA
Practice address
356 Totowa Ave
Paterson, NJ 07502-2137
Phone
(973) 904-0100
Fax
(973) 595-8286
NPI assigned
Mar 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2016

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

Authorized official

Name
Dr. Carlos A Tello, MD PA
Title
Medical Director
Phone
(973) 904-0100

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X 25MA04703100 NJ
Vascular Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0129X 25MA04703100 NJ
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X 25MA04703100 NJ Primary

Addresses

Primary practice location

356 Totowa Ave
Paterson, NJ 07502-2137

Mailing address

PO Box 2246
Paterson, NJ 07509-2246
Phone (973) 904-0100

Other identifiers 1

IdentifierTypeStateIssuer
6688900MedicaidNJ

Other names 1

  • Jen-Car Medical Associates Doing business as

National Provider Directory

National Provider Directory

Locations

356 Totowa Ave
Paterson, NJ 07502
Phone (973) 652-7554

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479254400000",
    "number": "1285765719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2246",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075092246",
            "telephone_number": "973-904-0100",
            "fax_number": "973-595-8286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "356 TOTOWA AVE",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075022137",
            "telephone_number": "973-904-0100",
            "fax_number": "973-595-8286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARLOS A TELLO, MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-08",
        "last_updated": "2016-11-16",
        "status": "A",
        "authorized_official_last_name": "TELLO",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "973-904-0100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD PA"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "NJ",
            "license": "25MA04703100",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "NJ",
            "license": "25MA04703100",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "NJ",
            "license": "25MA04703100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6688900",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jen-Car Medical Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Paterson, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2016; 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.