Individual provider Active NPI

Joaquin Cantillo, MD

  • Anesthesiology Physician
  • Trenton, NJ
National Provider Identifier
1639183908
Registry record updated Nov 1, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
05329100 Issued in NJ
Practice address
416 Bellevue Ave
Ste 104
Trenton, NJ 08618-4513
Phone
(609) 396-4700
NPI assigned
Jul 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 05329100 NJ Primary

Addresses

Primary practice location

416 Bellevue Ave
Ste 104
Trenton, NJ 08618-4513

Mailing address

804 Scott Nixon Memorial Dr
Augusta, GA 30907-2464

Other identifiers 1

IdentifierTypeStateIssuer
4010001MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050526001024 NJ Practitioner - Anesthesiology 9931148889 Reassigns benefits to 1 organization
I20190730001883 FL Practitioner - Anesthesiology 9931148889 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Puerto Rico School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sheridan Healthcorp IncGroup PAC ID 3173429693, 956 clinicians

Practice addresses (Care Compare)

1500 SE 1St Ave
Ocala, FL 34471-6504
Phone (352) 351-7200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
05329100NJMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sheridan Healthcorp Inc Anesthesiology Current Accepting new patients
Sheridan Healthcorp Inc Anesthesiology CurrentSince Jun 23, 2019 Accepting new patients
Sheridan Healthcorp, Inc. Anesthesiology CurrentSince Jun 23, 2019 Accepting new patients
New Jersey Healthcare Specialists PC Anesthesiology CurrentSince Apr 1, 2014 Accepting new patients
Trenton Anesthesiology Associates PA Anesthesiology Past Accepting new patients

Locations

1700 S 23rd St
Fort Pierce, FL 34950
Phone (772) 461-4000

11750 SW 40th St
Miami, FL 33175
Phone (305) 227-5544

1600 SE 17th St
Ocala, FL 34471
Phone (615) 240-3720

4600 SW 46th Ct
Ocala, FL 34474
Phone (352) 291-3000

1613 NW 136th Ave
Ste 200
Sunrise, FL 33323
Phone (954) 838-2502

901 W Main St
Freehold, NJ 07728
Phone (732) 294-2666

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

750 Brunswick Ave
Trenton, NJ 08638
Phone (609) 394-6000

Organizations & group practices 5

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 1

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": "1154131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193875200000",
    "number": "1639183908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 SCOTT NIXON MEMORIAL DR",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309072464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 BELLEVUE AVE",
            "address_2": "STE 104",
            "city": "TRENTON",
            "state": "NJ",
            "postal_code": "086184513",
            "telephone_number": "609-396-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANTILLO",
        "first_name": "JOAQUIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-29",
        "last_updated": "2007-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NJ",
            "license": "05329100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4010001",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Trenton, NJ

Sources for this page

Verify at the official NPI Registry.