Individual provider Active NPI

Frank Louis Gazzillo Jr., MD

  • Neurology Physician
  • Wayne, NJ
National Provider Identifier
1376643973
Registry record updated Jul 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
MA027433 Issued in NJ
Practice address
220 Hamburg Tpke
Suite 16
Wayne, NJ 07470-2110
Phone
(973) 942-4778
Fax
(973) 942-7020
NPI assigned
Sep 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X MA027433 NJ Primary

Addresses

Primary practice location

220 Hamburg Tpke
Suite 16
Wayne, NJ 07470-2110

Mailing address

220 Hamburg Tpke
Suite 16
Wayne, NJ 07470-2110
Phone (973) 942-4778

Other identifiers 1

IdentifierTypeStateIssuer
1322800MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101015001258 NJ Practitioner - Neurology 1759361116

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA027433NJMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Neurosurgical Associates of New Jersey, P.C. PastSince Aug 25, 2018 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1158969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277942400000",
    "number": "1376643973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 HAMBURG TPKE",
            "address_2": "SUITE 16",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074702110",
            "telephone_number": "973-942-4778",
            "fax_number": "973-942-7020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 HAMBURG TPKE",
            "address_2": "SUITE 16",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074702110",
            "telephone_number": "973-942-4778",
            "fax_number": "973-942-7020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAZZILLO",
        "first_name": "FRANK",
        "middle_name": "LOUIS",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-23",
        "last_updated": "2010-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NJ",
            "license": "MA027433",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1322800",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayne, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.