John F Bertagnolli Jr., D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MB04458900 Issued in NJ

Practice address

42 E Laurel Rd Ste 1800
Stratford, NJ 08084-1338

Phone

(856) 566-6843

Fax

(856) 566-6419

NPI assigned

Jan 19, 2006

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

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Samaritan Healthcare & Hospice Inc

  • Community Based Hospice Care Agency
  • Mount Laurel, NJ
  • NPI 1144227646

  W-2 Managing Employee

  CMS ownership

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.

• Rowansom New Jersey Institute for Successful Aging

  • Internal Medicine Physician
  • Stratford, NJ
  • NPI 1881666105

  Family Medicine

  NPD
• Rowansom Newjersey Institute for Successful Aging-Geriatric Psychiatry

  • Psychiatry Physician
  • Stratford, NJ
  • NPI 1881668846
  NPD
• Rowansom Dept of Pediatrics

  • Pediatrics Physician
  • Sewell, NJ
  • NPI 1275503203
  NPD (past)

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

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1295715787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 E LAUREL RD STE 1800",
            "city": "STRATFORD",
            "state": "NJ",
            "postal_code": "080841338",
            "telephone_number": "856-566-6843",
            "fax_number": "856-566-6419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 E LAUREL RD STE 1800",
            "city": "STRATFORD",
            "state": "NJ",
            "postal_code": "080841338",
            "telephone_number": "856-566-6843",
            "fax_number": "856-566-6419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTAGNOLLI",
        "first_name": "JOHN",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-19",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "MB04458900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7634501",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "104946CKP",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew Richard Bauer, D.O.
• Chanakya Bavishi, DO
• Melinda A. Beale, DO
• Bitha Beji
• Isabella Bentivogli
• Rafail Beshai, DO
• Sade Bethea
• Allen D Blaha, DPM
• Denise Valerie Blakney, LPN
• Lisa Marie Bodenheimer, LSW

• All providers in Stratford, NJ
• Family Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.