Organization Active NPI

Fernando Delasotta MD PA

  • Neurological Surgery Physician
  • Linwood, NJ
National Provider Identifier
1679647192
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
Legal business name
FERNANDO DELASOTTA MD PA
Practice address
598 New Rd
Linwood, NJ 08221-1241
Phone
(609) 927-1000
Fax
(609) 653-6852
NPI assigned
Nov 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Phyllis W Birnbaum
Title
Billing Manager
Phone
(609) 927-1000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207T00000X Primary

Addresses

Primary practice location

598 New Rd
Linwood, NJ 08221-1241

Mailing address

PO Box 385
598 New Rd
Linwood, NJ 08221-0385
Phone (609) 927-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050412000390 NJ Part B Supplier - Clinic/Group Practice 3870530884 Receives reassigned benefits from 2 practitioners
Practice locations: Linwood, NJ

National Provider Directory

National Provider Directory

Locations

222 New Rd
Linwood, NJ 08221
Phone (609) 653-4343

598 New Rd
Linwood, NJ 08221
Phone (609) 653-4359

Interoperability endpoints

  • Direct secure messaging: drdelasotta@fdmd.azalea.phimailbox.com

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1679647192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 385",
            "address_2": "598 NEW RD",
            "city": "LINWOOD",
            "state": "NJ",
            "postal_code": "082210385",
            "telephone_number": "609-927-1000",
            "fax_number": "609-653-6852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "598 NEW RD",
            "city": "LINWOOD",
            "state": "NJ",
            "postal_code": "082211241",
            "telephone_number": "609-927-1000",
            "fax_number": "609-653-6852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FERNANDO DELASOTTA MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BIRNBAUM",
        "authorized_official_first_name": "PHYLLIS",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "609-927-1000"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Linwood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.