William Ippolito, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

25MP00072000 Issued in NJ

Practice address

1825 Rte 35
Wall Township, NJ 07719-3541

Phone

(732) 280-2600

NPI assigned

Jan 3, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Summit Medical Group PAGroup PAC ID 5395642276, 1,204 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: william.ippolito@immcarenj.directbygreenway.com
• Direct secure messaging: william.ippolito.1@2983.direct.athenahealth.com

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.

• Summit Medical Group PA

  • Multi-Specialty Clinic/Center
  • Berkeley Heights, NJ
  • NPI 1942254347
  Medicare reassignment Care Compare group NPD
• Immediate Care Medical Walk-in of Hazlet, PA

  • Urgent Care Clinic/Center
  • Hazlet, NJ
  • NPI 1245595313
  Medicare reassignment
• The Physical Medicine Clinic LLC

  • Physical Medicine & Rehabilitation Physician
  • Woodbridge, NJ
  • NPI 1285922377
  Medicare reassignment
• Urgent Care Physicians of New Jersey, LLC

  • Emergency Medicine Physician
  • Red Bank, NJ
  • NPI 1447622402
  Medicare reassignment
• Summit Medical Group PA

  • Durable Medical Equipment & Medical Supplies
  • Hackensack, NJ
  • NPI 1043930555
  NPD
• Atlantic Professional Services of New Jersey, P.a.

  • Physician Assistant
  • Stratford, NJ
  • NPI 1932145182
  NPD (past)
• Evergreen Emergency Solutions, PC

  • Emergency Medicine Physician
  • Montclair, NJ
  • NPI 1558349274
  NPD (past)
• Middlesex Emergency Physicians, P.a.

  • Emergency Medicine Physician
  • Edison, NJ
  • NPI 1811921760

  Physician Assistant

  NPD (past)
• Plainfield Emergency Physicians, PA

  • Emergency Medicine Physician
  • Plainfield, NJ
  • NPI 1659309680

  Physician Assistant

  NPD (past)

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

{
    "created_epoch": "1136246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643673600000",
    "number": "1396723011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 PARSONAGE RD 102",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088372429",
            "telephone_number": "732-662-4680",
            "fax_number": "732-662-3354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 RTE 35",
            "city": "WALL TOWNSHIP",
            "state": "NJ",
            "postal_code": "077193541",
            "telephone_number": "732-280-2600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Bay Ave",
            "address_2": "Evergreen Emergency Physicians",
            "address_purpose": "LOCATION",
            "city": "Montclair",
            "state": "NJ",
            "postal_code": "070424837",
            "country_code": "US",
            "telephone_number": "973-429-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IPPOLITO",
        "first_name": "WILLIAM",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-03",
        "last_updated": "2022-02-01",
        "certification_date": "2022-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00072000",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NJ",
            "license": "25MP00072000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelli Alisa Hudson, ATC
• Samantha Hummel
• Scott Steinez Hyppolite, DC
• Cristina Imburgia, FNP-BC
• Avery Ingold, MS, CCC-SLP
• Christina Jamieson, APN
• Tsaiwen Jau, M.A., CCC-SLP
• Madeline Jean-Mary, LSW
• Jersey Coast Physical Therapy Inc.
• Jersey Shore Institute of Health and Wellness

• Medical Physician Assistant in Wall Township, NJ
• Providers in Wall Township, NJ by specialty
• Medical Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.