Jesus Octavio Amador, IDMT

Primary specialty

Independent Duty Medical TechniciansTaxonomy code 1710I1003X

Practice address

2305 Saxony Dr
Mount Laurel, NJ 08054-6806

Phone

(310) 856-9968

NPI assigned

Jul 21, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• United States Air Force

  • Military Hospital
  • NPI 1396972238
  NPD (past) Authorized official

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

{
    "created_epoch": "1248134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248134400000",
    "number": "1457581704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2305 SAXONY DR",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080546806",
            "telephone_number": "310-856-9968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2305 SAXONY DR",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080546806",
            "telephone_number": "310-856-9968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMADOR",
        "first_name": "JESUS",
        "middle_name": "OCTAVIO",
        "credential": "IDMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-21",
        "last_updated": "2009-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1003X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Medical Technicians",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allies, Inc.
• Allies, Inc.
• Allies, Inc.
• Kali Alston
• Always There in Home Health Care
• Amazing Grace Community Support LLC
• Brooke T Ambert, BCBA
• Nicole Ambrose, DO
• Ambulatory Foot and Ankle Associates LLC
• American Current Care of New Jersey PA

• Independent Duty Medical Technicians in Mount Laurel, NJ
• Providers in Mount Laurel, NJ by specialty
• Independent Duty Medical Technicians in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.