Individual provider Active NPI

John Kintiroglou, M.D.

  • Pediatrics Physician
  • West Orange, NJ
National Provider Identifier
1528198645
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MA06840800 Issued in NJ
Practice address
1500 Pleasant Valley Way
Ste 306
West Orange, NJ 07052-2956
Phone
(973) 243-0002
Fax
(973) 243-1227
NPI assigned
Mar 7, 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
Pediatrics Physician 208000000X MA06840800 NJ Primary

Addresses

Primary practice location

1500 Pleasant Valley Way
Ste 306
West Orange, NJ 07052-2956

Mailing address

109 Parks Rd
Denville, NJ 07834-2433
Phone (973) 664-1241

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200205000885 NJ Practitioner - Pediatric Medicine 6002242302 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA06840800NJMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advocare , LLC CurrentSince Jan 17, 2020 Accepting new patients
Advocare, LLC Pediatrics CurrentSince Jan 17, 2020 Accepting new patients
Advocare, LLC Pediatrics Past Accepting new patients
Kintiroglou Pediatrics LLC Pediatrics Past Accepting new patients
Cooperman Barnabas Medical Center Inc Past Accepting new patients

Locations

7 James St
Fl 1
Florham Park, NJ 07932

7 James St
Florham Park, NJ 07932
Phone (973) 295-6226

132 Grove St
Ste A
Haddonfield, NJ 08033
Phone (856) 354-2211

401 Route 73 N
Ste 320
Marlton, NJ 08053
Phone (609) 471-1033

745 Northfield Ave
Ste 7
West Orange, NJ 07052
Phone (973) 243-0002

Organizations & group practices 5

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": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1528198645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 PARKS RD",
            "city": "DENVILLE",
            "state": "NJ",
            "postal_code": "078342433",
            "telephone_number": "973-664-1241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 PLEASANT VALLEY WAY",
            "address_2": "STE 306",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070522956",
            "telephone_number": "973-243-0002",
            "fax_number": "973-243-1227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINTIROGLOU",
        "first_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "MA06840800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Orange, NJ

Sources for this page

Verify at the official NPI Registry.