Individual provider Active NPI

Anthony Scardella

  • Pulmonary Disease Physician
  • Monroe TWP, NJ
National Provider Identifier
1659313609
Registry record updated Oct 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
MA035545 Issued in NJ
Practice address
11 Centre Dr
Suite a
Monroe TWP, NJ 08831-1564
Phone
(609) 395-2460
Fax
(609) 409-3985
NPI assigned
Jun 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X MA035545 NJ Primary

Addresses

Primary practice location

11 Centre Dr
Suite a
Monroe TWP, NJ 08831-1564

Mailing address

66 West Gilbert St
Red Bank, NJ 07701
Phone (732) 212-0051

Other identifiers 2

IdentifierTypeStateIssuer
0460206MedicaidNJ
290003883OtherNJRAILROAD MEDICARE PTAN

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
I20050720000659 NJ Practitioner - Pulmonary Disease 3971530072 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA035545NJMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rutgers Health-RWJ Scleroderma Program Pulmonary Disease CurrentSince May 10, 2005 Accepting new patients
Saint Peter'S University Hospital Past Accepting new patients

Locations

125 Paterson St
Ste 52008
New Brunswick, NJ 08901

125 Paterson St
New Brunswick, NJ 08901
Phone (732) 235-6511

253 Witherspoon St
Princeton, NJ 08540
Phone (609) 497-4000

66 W Gilbert St
Tinton Falls, NJ 07701
Phone (732) 212-0051

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8568/brand/1/csg/1/fhir/r4

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225152000000",
    "number": "1659313609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 WEST GILBERT ST",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "07701",
            "telephone_number": "732-212-0051",
            "fax_number": "732-212-0713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 CENTRE DR",
            "address_2": "SUITE A",
            "city": "MONROE TWP",
            "state": "NJ",
            "postal_code": "088311564",
            "telephone_number": "609-395-2460",
            "fax_number": "609-409-3985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCARDELLA",
        "first_name": "ANTHONY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2008-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NJ",
            "license": "MA035545",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0460206",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PTAN",
            "identifier": "290003883",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe TWP, NJ

Sources for this page

Verify at the official NPI Registry.