Individual provider Active NPI

Mark McCaffery, D.M.D.

  • General Practice Dentistry
  • Madison, NJ
National Provider Identifier
1679655658
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
22D101538800 Issued in NJ
Practice address
303 Main St
Madison, NJ 07940-2338
Phone
(973) 966-6997
Fax
(973) 966-5512
NPI assigned
Oct 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 22D101538800 NJ Primary

Addresses

Primary practice location

303 Main St
Madison, NJ 07940-2338

Mailing address

303 Main St
Madison, NJ 07940-2338
Phone (973) 966-6997

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160527001098 NJ Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 3476843707

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22D101538800NJMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679655658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 MAIN ST",
            "city": "MADISON",
            "state": "NJ",
            "postal_code": "079402338",
            "telephone_number": "973-966-6997",
            "fax_number": "973-966-5512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 MAIN ST",
            "city": "MADISON",
            "state": "NJ",
            "postal_code": "079402338",
            "telephone_number": "973-966-6997",
            "fax_number": "973-966-5512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCAFFERY",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22D101538800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, NJ

Sources for this page

Verify at the official NPI Registry.