Individual provider Active NPI

Vincent Carrao, DDS, MD

  • Oral and Maxillofacial Pathology Dentistry
  • Fort Lee, NJ
National Provider Identifier
1417945767
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X
License
DI020747 Issued in NJ
Practice address
1530 Palisade Ave
Fort Lee, NJ 07024-5471
Phone
(201) 585-8282
Fax
(201) 585-0805
NPI assigned
Oct 11, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Pathology Dentistry 1223P0106X DI020747 NJ Primary

Addresses

Primary practice location

1530 Palisade Ave
Fort Lee, NJ 07024-5471

Mailing address

1530 Palisade Ave
Fort Lee, NJ 07024-5471
Phone (201) 585-8282

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20041027000946 NJ Practitioner - Maxillofacial Surgery 6901868405 Reassigns benefits to 1 organization
I20050216000617 NY Practitioner - Maxillofacial Surgery 6901868405 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Maxillofacial Surgery
Education
Columbia University College of Dental Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1530 Palisade Ave
Fort Lee, NJ 07024-5471
Phone (201) 585-8282

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Oral Surgery Alliance of New Jersey, LLC CurrentSince Aug 14, 2024 Accepting new patients
Icahn School of Medicine at Mount Sinai Current Accepting new patients

Locations

1530 Palisade Ave
Fort Lee, NJ 07024
Phone (201) 363-8871

69 1st Ave
Raritan, NJ 08869
Phone (800) 631-5250

5 E 98th St
New York, NY 10029
Phone (212) 241-3986

150 E 42nd St
Fl 10
New York, NY 10017
Phone (646) 605-8119

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1128988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1417945767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1530 PALISADE AVE",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070245471",
            "telephone_number": "201-585-8282",
            "fax_number": "201-585-0805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 PALISADE AVE",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070245471",
            "telephone_number": "201-585-8282",
            "fax_number": "201-585-0805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRAO",
        "first_name": "VINCENT",
        "name_prefix": "Dr.",
        "credential": "DDS, MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-11",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "NJ",
            "license": "DI020747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lee, NJ

Sources for this page

Verify at the official NPI Registry.