Individual provider Active NPI

James Burke Fine, D.M.D

  • Periodontics
  • Mountainside, NJ
National Provider Identifier
1447378633
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
22DI01360804 Issued in NJ
Practice address
213 Summit Rd
Mountainside, NJ 07092-2316
Phone
(908) 654-4949
Fax
(201) 792-7677
NPI assigned
Mar 26, 2007
Sex
Male
Sole proprietor
No

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
Periodontics 1223P0300X 22DI01360804 NJ Primary

Addresses

Primary practice location

213 Summit Rd
Mountainside, NJ 07092-2316

Mailing address

213 Summit Rd
Mountainside, NJ 07092-2316
Phone (908) 654-4949

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160722000014 NY Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 8921391392

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22DI01360804NJMDPeriodontist

Interoperability endpoints

  • Direct secure messaging: finejam@direct.nyp.org

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1447378633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 SUMMIT RD",
            "city": "MOUNTAINSIDE",
            "state": "NJ",
            "postal_code": "070922316",
            "telephone_number": "908-654-4949",
            "fax_number": "201-792-7677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 SUMMIT RD",
            "city": "MOUNTAINSIDE",
            "state": "NJ",
            "postal_code": "070922316",
            "telephone_number": "908-654-4949",
            "fax_number": "201-792-7677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FINE",
        "first_name": "JAMES",
        "middle_name": "BURKE",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NJ",
            "license": "22DI01360804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountainside, NJ

Sources for this page

Verify at the official NPI Registry.