Individual provider Active NPI

Nicholas A. Cunicella III, D.O.

  • Family Medicine Physician
  • Scotch Plains, NJ
National Provider Identifier
1568514784
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MB04899100 Issued in NJ
Practice address
2314 South Ave
Scotch Plains, NJ 07076-4667
Phone
(908) 233-6660
Fax
(908) 654-7152
NPI assigned
Jan 17, 2007
Sex
Male
Sole proprietor
Yes

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
Family Medicine Physician 207Q00000X 25MB04899100 NJ Primary

Addresses

Primary practice location

2314 South Ave
Scotch Plains, NJ 07076-4667

Mailing address

2314 South Ave
Scotch Plains, NJ 07076-4667
Phone (908) 233-6660

Other identifiers 1

IdentifierTypeStateIssuer
17101606MedicaidNJ

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
I20120221000668 NJ Practitioner - Family PracticePractitioner - Emergency Medicine 6406014521 Practice locations: Scotch Plains, NJ

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2314 S Ave
Scotch Plains, NJ 07076-4667
Phone (908) 233-6660

Hospital & facility affiliations

  • Atlantic Visiting Nurse Home health agency, Morristown, NJ, CCN 317054
  • Morristown Medical Center Hospital, Morristown, NJ, CCN 310015

National Provider Directory

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

Hospital & facility affiliations 2

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": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1568514784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2314 SOUTH AVE",
            "city": "SCOTCH PLAINS",
            "state": "NJ",
            "postal_code": "070764667",
            "telephone_number": "908-233-6660",
            "fax_number": "908-654-7152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2314 SOUTH AVE",
            "city": "SCOTCH PLAINS",
            "state": "NJ",
            "postal_code": "070764667",
            "telephone_number": "908-233-6660",
            "fax_number": "908-654-7152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNICELLA",
        "first_name": "NICHOLAS",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MB04899100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "17101606",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scotch Plains, NJ

Sources for this page

Verify at the official NPI Registry.