Individual provider Active NPI

John T Coppola, MD

  • Interventional Cardiology Physician
  • Colts Neck, NJ
National Provider Identifier
1558334375
Registry record updated Sep 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
25MA12855200 Issued in NJ
Practice address
340 Route 34 Ste 201
Colts Neck, NJ 07722-2434
Phone
(732) 487-3636
Fax
(732) 487-3635
NPI assigned
Feb 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X 25MA12855200 NJ Primary

Addresses

Primary practice location

340 Route 34 Ste 201
Colts Neck, NJ 07722-2434

Mailing address

340 Route 34 Ste 201
Colts Neck, NJ 07722-2434
Phone (732) 487-3636

Other identifiers 1

IdentifierTypeStateIssuer
00757855MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040529000125 NY Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 9335120732 Reassigns benefits to 1 organization
I20260311000336 NJ Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 9335120732 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
New York Medical College, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Heart and Vascular of Central JerseyGroup PAC ID 4486074549, 3 clinicians

Practice addresses (Care Compare)

340 Route 34
Suite 201
Colts Neck, NJ 07722-2434
Phone (732) 487-3636

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA12855200NJMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Heart and Vascular of Central Jersey Cardiovascular Disease CurrentSince Jan 12, 2026 Accepting new patients
New York University Cardiovascular Disease CurrentSince May 1, 2011 Accepting new patients
New York University Cardiovascular Disease CurrentSince May 1, 2011 Accepting new patients
St Vincents Hospital and Medical Center Past Accepting new patients
Medical Service of St Vincent'S Hospital &Medical Center, P.C. Cardiovascular Disease Past Accepting new patients

Locations

340 State Route 34
Ste 201
Colts Neck, NJ 07722
Phone (732) 487-3636

275 7th Ave
Fl 3
New York, NY 10001
Phone (646) 660-9999

550 1st Ave
New York, NY 10016
Phone (212) 263-3293

301 E 17th St
New York, NY 10003
Phone (212) 460-0125

Interoperability endpoints

  • Direct secure messaging: jcoppola674233@nychhc.direct-ci.com

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": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757462400000",
    "number": "1558334375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 ROUTE 34 STE 201",
            "city": "COLTS NECK",
            "state": "NJ",
            "postal_code": "077222434",
            "telephone_number": "732-487-3636",
            "fax_number": "732-487-3635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 ROUTE 34 STE 201",
            "city": "COLTS NECK",
            "state": "NJ",
            "postal_code": "077222434",
            "telephone_number": "732-487-3636",
            "fax_number": "732-487-3635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COPPOLA",
        "first_name": "JOHN",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-10",
        "last_updated": "2025-09-10",
        "certification_date": "2025-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NJ",
            "license": "25MA12855200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00757855",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colts Neck, NJ

Sources for this page

Verify at the official NPI Registry.