Individual provider Active NPI

John Frattarola, MD

  • Specialist
  • Teaneck, NJ
National Provider Identifier
1609836592
Registry record updated Jun 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
25MA03819000 Issued in NJ
Practice address
870 Palisade Ave
Teaneck, NJ 07666-3419
Phone
(201) 907-0900
Fax
(201) 907-0229
NPI assigned
Mar 24, 2006
Last updated
Jun 10, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 25MA03819000 NJ Primary

Addresses

Primary practice location

870 Palisade Ave
Teaneck, NJ 07666-3419

Mailing address

870 Palisade Ave
Teaneck, NJ 07666-3419
Phone (201) 907-0900

Other identifiers 11

IdentifierTypeStateIssuer
0073913000OtherNJAMERIHEALTH ID #
1160888OtherNJHORIZON NJ HEALTH
160041568OtherNJRAILROAD MEDICARE
24464OtherNJAMERICAID AMERIGROUP
17258OtherNJUNIVERSITY HEALTH PLANS
1042435OtherNJHORIZON NJ HEALTH ID #
3287203MedicaidNJ
2K1111OtherNJHEALTHNET
560039OtherNJAETNA HMO ID #
4401167OtherNJAETNA PPO ID #
BP355OtherNJOXFORD ID #

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
I20080913000001 NJ Practitioner - Obstetrics/Gynecology 2365518487 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Holy Name Medical Associates, PCGroup PAC ID 9436442712, 6 clinicians

Practice addresses (Care Compare)

870 Palisade Ave
Suite 301
Teaneck, NJ 07666-3446
Phone (201) 907-0900

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA03819000NJMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Holy Name Medical Associates, PC CurrentSince Nov 1, 2016 Accepting new patients
Excelcare Medical Associates, PA PastSince Nov 1, 2016 Accepting new patients

Locations

71 Union Ave
Ste 101
Rutherford, NJ 07070
Phone (201) 933-4775

718 Teaneck Rd
Teaneck, NJ 07666
Phone (201) 833-3232

870 Palisade Ave
Teaneck, NJ 07666
Phone (201) 907-0900

870 Palisade Ave
Ste 301
Teaneck, NJ 07666
Phone (201) 907-0900

Interoperability endpoints

  • Direct secure messaging: frattarola@whcgnj.ssdirect.aprima.com

Organizations & group practices 3

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 5

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": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213056000000",
    "number": "1609836592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "870 PALISADE AVE",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076663419",
            "telephone_number": "201-907-0900",
            "fax_number": "201-907-0229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "870 PALISADE AVE",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076663419",
            "telephone_number": "201-907-0900",
            "fax_number": "201-907-0229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRATTAROLA",
        "first_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2008-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NJ",
            "license": "25MA03819000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH ID #",
            "identifier": "0073913000",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON NJ HEALTH",
            "identifier": "1160888",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "160041568",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAID AMERIGROUP",
            "identifier": "24464",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERSITY HEALTH PLANS",
            "identifier": "17258",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON NJ HEALTH ID #",
            "identifier": "1042435",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3287203",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "2K1111",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO ID #",
            "identifier": "560039",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO ID #",
            "identifier": "4401167",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD ID #",
            "identifier": "BP355",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Teaneck, NJ

Sources for this page

Verify at the official NPI Registry.