Active NPI
John Joseph Millili, M.D.
- Surgery Physician
- Woodbury, NJ
National Provider Identifier
1609897198
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 25MA04424200
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0456585000 | Other | PA | AMERIHEALTH |
| 2356805 | Medicaid | NJ | |
| 0011963240003 | Medicaid | PA | |
| 0075290000 | Other | NJ | AMERIHEALTH |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA04424200 | NJ | MD | Surgery Physician |
| MD024812E | PA | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Surgical & Critical Care Associates | Surgery | Past | 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.
-
- Surgery Physician
- Woodbury, NJ
- NPI 1083631733
-
- Surgical Critical Care Physician
- Media, PA
- NPI 1083994149
-
- Nurse Practitioner
- Media, PA
- NPI 1326205972
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.