Individual provider Active NPI

David Michael Sileo, RN MS ACNP-BC

  • Nurse Practitioner
  • West Deptford, NJ
National Provider Identifier
1619234382
Registry record updated Dec 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
26NJ00689900 Issued in NJ
Practice address
1014 Juniper
West Deptford, NJ 08096
Phone
(856) 848-6882
NPI assigned
Apr 18, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 26NJ00689900 NJ Primary
Nurse Practitioner 363L00000X SP016182 PA

Addresses

Primary practice location

1014 Juniper
West Deptford, NJ 08096

Mailing address

1014 Juniper CT
West Deptford, NJ 08096-5728
Phone (856) 371-3919

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171005002353 NJ Practitioner - Nurse Practitioner 2264707967 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
26NJ00689900NJMDNurse Practitioner
SP016182PAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Virtua Medical Group, PA Nurse Practitioner CurrentSince Feb 1, 2022 Accepting new patients
Virtua Medical Group, PA CurrentSince Feb 1, 2022 Accepting new patients
Virtua Medical Group, PA Current Accepting new patients

Locations

3242 Route 206
Ste 2
Bordentown, NJ 08505
Phone (609) 298-4340

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1334707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640131200000",
    "number": "1619234382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1014 JUNIPER CT",
            "city": "WEST DEPTFORD",
            "state": "NJ",
            "postal_code": "080965728",
            "telephone_number": "856-371-3919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1014 JUNIPER",
            "city": "WEST DEPTFORD",
            "state": "NJ",
            "postal_code": "08096",
            "telephone_number": "856-848-6882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SILEO",
        "first_name": "DAVID",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "RN MS ACNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-18",
        "last_updated": "2021-12-22",
        "certification_date": "2021-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ00689900",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP016182",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Deptford, NJ

Sources for this page

Verify at the official NPI Registry.