Active NPI
Vincent Disabella, DO
- Sports Medicine (Internal Medicine) Physician
- Vineland, NJ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Medicine (Internal Medicine) Physician
- License
- 25MB06246100
- Practice address
- 352 S Delsea Dr Ste C
Vineland, NJ 08360-5306 - Phone
- (856) 690-1616
- Fax
- (856) 896-6107
- NPI assigned
- Jan 4, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Medicine (Internal Medicine) Physician | 207RS0010X | C2-0005338 | DE | |
| Sports Medicine (Internal Medicine) Physician | 207RS0010X | 25MB06246100 | NJ | Primary |
Addresses
Primary practice location
352 S Delsea Dr Ste C
Vineland, NJ 08360-5306
Mailing address
352 S Delsea Dr Ste C
Vineland, NJ 08360-5306
Phone (856) 690-1616
Other identifiers 11
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5091134 | Other | DE | CIGNA |
| 981003 | Medicaid | DE | |
| 1316962 | Other | DE | AETNA HMO |
| 204753265 | Other | DE | TRICARE |
| 3156674 | Other | DE | UNITED HEALTH CARE |
| 2803741000 | Other | DE | AMERIHEALTH |
| 204753265 | Other | DE | BLUE CROSS BLUE SHEILD DE |
| 2803109000 | Other | DE | INDEPENDENCE BLUE CROSS |
| 442146 | Other | DE | COVENTRY |
| 5933380 | Other | DE | AETNA PPO |
| 20-4753265 | Other | DE | NATIONAL PROVIDER NETWORK |
Medicare participation
Medicare enrollment files- 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: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Sports Medicine
- Education
- Philadelphia College of Osteopathic Medicine, 1992
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
201 Tomlin Station Rd C
Mullica Hill, NJ 08062-1612
Phone (856) 690-1616
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C2-0005338 | DE | MD | Sports Medicine (Internal Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Premier Orthopaedic and Sports Medicine Assoc of Southern NJ LLC | Current | Accepting new patients | |
| Premier Orthopaedic and Sports Medicine Assoc of Southern NJ LLC | Current | Accepting new patients |
Locations
201 Tomlin Station Rd
Ste C
Mullica Hill, NJ 08062
352 S Delsea Dr
Unit C
Vineland, NJ 08360
Phone 8566901616 ext. 6021
298 S Delsea Dr
Vineland, NJ 08360
Phone (356) 690-1616
Interoperability endpoints
- vincent.disabella@poasnj.eclinicaldirectplus.com
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.
-
- Orthopaedic Surgery Physician
- Vineland, NJ
- NPI 1396812574
-
- Orthopaedic Surgery Physician
- Mullica Hill, NJ
- NPI 1457092611
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Vineland, NJ
- NPI 1164487542
-
- General Acute Care Hospital
- Elmer, NJ
- NPI 1255396024
-
- General Acute Care Hospital
- Mullica Hill, NJ
- NPI 1366097032
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136332800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1633910400000",
"number": "1487632170",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "352 S DELSEA DR STE C",
"city": "VINELAND",
"state": "NJ",
"postal_code": "083605306",
"telephone_number": "856-690-1616",
"fax_number": "856-896-6107"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "352 S DELSEA DR STE C",
"city": "VINELAND",
"state": "NJ",
"postal_code": "083605306",
"telephone_number": "856-690-1616",
"fax_number": "856-896-6107"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DISABELLA",
"first_name": "VINCENT",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-04",
"last_updated": "2021-10-11",
"certification_date": "2021-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "207RS0010X",
"taxonomy_group": "",
"desc": "Internal Medicine, Sports Medicine",
"state": "DE",
"license": "C2-0005338",
"primary": false
},
{
"code": "207RS0010X",
"taxonomy_group": "",
"desc": "Internal Medicine, Sports Medicine",
"state": "NJ",
"license": "25MB06246100",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "5091134",
"state": "DE"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "981003",
"state": "DE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA HMO",
"identifier": "1316962",
"state": "DE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "204753265",
"state": "DE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTH CARE",
"identifier": "3156674",
"state": "DE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIHEALTH",
"identifier": "2803741000",
"state": "DE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHEILD DE",
"identifier": "204753265",
"state": "DE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INDEPENDENCE BLUE CROSS",
"identifier": "2803109000",
"state": "DE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COVENTRY",
"identifier": "442146",
"state": "DE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA PPO",
"identifier": "5933380",
"state": "DE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NATIONAL PROVIDER NETWORK",
"identifier": "20-4753265",
"state": "DE"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Vineland, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2021; 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.