Individual provider Active NPI

John Joseph Millili, M.D.

  • Surgery Physician
  • Woodbury, NJ
National Provider Identifier
1609897198
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
25MA04424200 Issued in NJ
Practice address
127 N Broad St
Woodbury, NJ 08096-1718
Phone
(856) 845-0500
Fax
(856) 384-8757
NPI assigned
Jul 21, 2006
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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 25MA04424200 NJ Primary
Surgery Physician 208600000X MD024812E PA

Addresses

Primary practice location

127 N Broad St
Woodbury, NJ 08096-1718

Mailing address

127 N Broad St
Woodbury, NJ 08096-1718
Phone (856) 845-0500

Other identifiers 4

IdentifierTypeStateIssuer
0456585000OtherPAAMERIHEALTH
2356805MedicaidNJ
0011963240003MedicaidPA
0075290000OtherNJAMERIHEALTH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA04424200NJMDSurgery Physician
MD024812EPAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Surgical & Critical Care Associates Surgery PastSince Aug 1, 2007 Accepting new patients
Mobile Wound Consultants Inc Past Accepting new patients
Mobile Wound Consultants II Inc. Past Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609897198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 N BROAD ST",
            "city": "WOODBURY",
            "state": "NJ",
            "postal_code": "080961718",
            "telephone_number": "856-845-0500",
            "fax_number": "856-384-8757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 N BROAD ST",
            "city": "WOODBURY",
            "state": "NJ",
            "postal_code": "080961718",
            "telephone_number": "856-845-0500",
            "fax_number": "856-384-8757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLILI",
        "first_name": "JOHN",
        "middle_name": "JOSEPH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NJ",
            "license": "25MA04424200",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MD024812E",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "0456585000",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2356805",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0011963240003",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "0075290000",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.