Individual provider Active NPI

Gerard M Monticollo, D.O.

  • Pain Medicine (Anesthesiology) Physician
  • Camden, NJ
National Provider Identifier
1376586487
Registry record updated Feb 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
MBD47338 Issued in NJ
Practice address
1600 Haddon Ave FL 3
Camden, NJ 08103-3101
Phone
(856) 988-6260
NPI assigned
Jun 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X MBD47338 NJ Primary

Addresses

Primary practice location

1600 Haddon Ave FL 3
Camden, NJ 08103-3101

Mailing address

301 Lippincott Dr Ste 410
Marlton, NJ 08053-4197
Phone (856) 355-0340

Other practice location 1

1600 Haddon Ave
Camden, NJ 08103-3101
Phone (856) 757-3836

Other identifiers 7

IdentifierTypeStateIssuer
010064263OtherNJRAILROAD MEDICARE
222041639OtherNJTAX ID
1122473OtherNJHORIZON NJ HEALTH
95976OtherNJAMERIGROUP
2012707MedicaidNJ
0009928OtherNJAETNA
2190722000OtherNJAMERIHEALTH

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
I20041215000685 NJ Practitioner - Anesthesiology 5698688976 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Rutgers New Jersey Medical School, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Virtua Medical Group, PAGroup PAC ID 9830222397, 1,678 clinicians

Practice addresses (Care Compare)

1600 Haddon Ave
Camden, NJ 08103-3101

3242 Route 206
Bordentown, NJ 08505-4517

Hospital & facility affiliations

  • Virtua Our Lady of Lourdes Hospital Hospital, Camden, NJ, CCN 310029
  • West Jersey Hospital Hospital, Voorhees, NJ, CCN 310022

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MBD47338NJMDPain Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Virtua Medical Group, PA Current Accepting new patients
Virtua Medical Group, PA CurrentSince Mar 1, 2025 Accepting new patients
Virtua Medical Group, PA CurrentSince Mar 1, 2025 Accepting new patients
Mid-Atlantic Anesthesia Associates PA Pain Medicine CurrentSince Mar 30, 2000 Accepting new patients

Locations

3242 Route 206
Ste 2
Bordentown, NJ 08505
Phone (609) 298-4340

1600 Haddon Ave
Camden, NJ 08103
Phone (609) 757-3500

1600 Haddon Ave
#L
Camden, NJ 08103
Phone (856) 757-3500

1600 Haddon Ave
Fl 3
Camden, NJ 08103
Phone (609) 988-6260

301 Lippincott Dr
Ste 410
Marlton, NJ 08053

Interoperability endpoints

  • Direct secure messaging: gmonticollo136219@directvirtua.org

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1376586487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 LIPPINCOTT DR STE 410",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080534197",
            "telephone_number": "856-355-0340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 HADDON AVE FL 3",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081033101",
            "telephone_number": "856-988-6260"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 Haddon Ave",
            "address_purpose": "LOCATION",
            "city": "Camden",
            "state": "NJ",
            "postal_code": "081033101",
            "country_code": "US",
            "telephone_number": "856-757-3836",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONTICOLLO",
        "first_name": "GERARD",
        "middle_name": "M",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NJ",
            "license": "MBD47338",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "010064263",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "222041639",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON NJ HEALTH",
            "identifier": "1122473",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "95976",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2012707",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0009928",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "2190722000",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Camden, NJ

Sources for this page

Verify at the official NPI Registry.