Individual provider Active NPI

John G Ciciarelli II, MD

  • Internal Medicine Physician
  • Oakhurst, NJ
National Provider Identifier
1629085691
Registry record updated Sep 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MA41425 Issued in NJ
Practice address
1900 RT 35
Oakhurst, NJ 07755
Phone
(732) 663-0900
Fax
(732) 663-0901
NPI assigned
Aug 2, 2006
Last updated
Sep 24, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MA41425 NJ Primary

Addresses

Primary practice location

1900 RT 35
Oakhurst, NJ 07755

Mailing address

1900 RT 35
Suite 200
Oakhurst, NJ 07755
Phone (732) 663-0900

Other identifiers 1

IdentifierTypeStateIssuer
3176801MedicaidNJ

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
I20120221000493 NJ Practitioner - Internal Medicine 9739174426 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA41425NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hackensack Meridian Health Medical Group - Primary Care PC Internal Medicine CurrentSince Oct 1, 2013 Accepting new patients
Shore Health Group, PC Internal Medicine Past Accepting new patients

Locations

985 Cedar Bridge Ave
Brick, NJ 08723
Phone (732) 477-5600

1900 State Route 35
Oakhurst, NJ 07755
Phone (732) 517-1552

1900 State Route 35
Ste 200
Oakhurst, NJ 07755
Phone (732) 502-9339

Interoperability endpoints

  • FHIR API: https://mepic.hmhn.org/fhir/api/FHIR/R4/
  • Direct secure messaging: john.ciciarelli@direct.hackensackmeridian.org

Organizations & group practices 2

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": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379980800000",
    "number": "1629085691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 RT 35",
            "address_2": "SUITE 200",
            "city": "OAKHURST",
            "state": "NJ",
            "postal_code": "07755",
            "telephone_number": "732-663-0900",
            "fax_number": "732-663-0901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 RT 35",
            "city": "OAKHURST",
            "state": "NJ",
            "postal_code": "07755",
            "telephone_number": "732-663-0900",
            "fax_number": "732-663-0901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CICIARELLI",
        "first_name": "JOHN",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-02",
        "last_updated": "2013-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "MA41425",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3176801",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakhurst, NJ

Sources for this page

Verify at the official NPI Registry.