NPIMap

Individual provider Active NPI

Donald M Micallef, MD

  • Internal Medicine Physician
  • Spring Lake, NJ
National Provider Identifier
1467486365
Registry record updated May 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MA55294 Issued in NJ
Practice address
512 Warren Ave
Spring Lake, NJ 07762-1233
Phone
(732) 449-0063
Fax
(732) 449-7073
NPI assigned
Jul 10, 2006
Last updated
May 18, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 18, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MA55294 NJ Primary

Addresses

Primary practice location

512 Warren Ave
Spring Lake, NJ 07762-1233

Mailing address

512 Warren Ave
Spring Lake, NJ 07762-1233
Phone (732) 449-0063

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040806000340 NJ Practitioner - Internal Medicine 3577535012 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Partners in Freedom LLCGroup PAC ID 1254318256, 3 clinicians

Practice addresses (Care Compare)

3350 Hwy 138
Suite 217
Wall Township, NJ 07719-9694
Phone 7329741980111

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA55294NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Autumn Ridge Primary Care LLC Internal Medicine CurrentSince Mar 9, 2020 Accepting new patients
Shore Primary Care, P.C. Internal Medicine PastSince Apr 1, 2001 Accepting new patients

Locations

3350 State Route 138
Ste 217
Wall Township, NJ 07719
Phone (732) 974-1980

Interoperability endpoints

  • Direct secure messaging: donaldmicallef@pfllc.allscriptsdirect.net

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Embracing Hospice CareWall, NJ, CCN 311556 Hospice Contracted Managing Employee Jan 2, 2023

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431907200000",
    "number": "1467486365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 WARREN AVE",
            "city": "SPRING LAKE",
            "state": "NJ",
            "postal_code": "077621233",
            "telephone_number": "732-449-0063",
            "fax_number": "732-449-7073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "512 WARREN AVE",
            "city": "SPRING LAKE",
            "state": "NJ",
            "postal_code": "077621233",
            "telephone_number": "732-449-0063",
            "fax_number": "732-449-7073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICALLEF",
        "first_name": "DONALD",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2015-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "MA55294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spring Lake, NJ

Sources for this page

Verify at the official NPI Registry.