Individual provider Active NPI

Matthew J Parisi Jr., RPH

  • Pharmacist
  • Newark, NJ
National Provider Identifier
1306057864
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
28RI01375800 Issued in NJ
Practice address
794 Mount Prospect Ave
Newark, NJ 07104-3221
Phone
(973) 483-4749
Fax
(973) 482-0643
NPI assigned
May 25, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 28RI01375800 NJ Primary

Addresses

Primary practice location

794 Mount Prospect Ave
Newark, NJ 07104-3221

Mailing address

9 Lower Overlook Rd
Gillette, NJ 07933-1507
Phone (908) 647-1396

Other identifiers 1

IdentifierTypeStateIssuer
28RI001375800OtherNJSTATE PHARMACIST LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
28RI01375800NJMDPharmacist

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306057864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 LOWER OVERLOOK RD",
            "city": "GILLETTE",
            "state": "NJ",
            "postal_code": "079331507",
            "telephone_number": "908-647-1396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "794 MOUNT PROSPECT AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071043221",
            "telephone_number": "973-483-4749",
            "fax_number": "973-482-0643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARISI",
        "first_name": "MATTHEW",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI01375800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE PHARMACIST LICENSE",
            "identifier": "28RI001375800",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.