Drc360, LLC

Primary specialty

Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X

Legal business name

DRC360, LLC

Practice address

29 South St
New Providence, NJ 07974-2934

Phone

(973) 452-9078

NPI assigned

Feb 11, 2015

Organization subpart

No

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

Authorized official

Name

Anthony Richard CavazosNPI 1104944263

Title

Owner

Phone

(973) 452-9078

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 2

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

• Anthony R Cavazos, M.D.

  • Geriatric Medicine (Family Medicine) Physician
  • New Providence, NJ
  • NPI 1104944263
  Medicare reassignment NPD Authorized official
• Zina B. Cappiello, D.P.M.

  • Podiatrist
  • Cedar Grove, NJ
  • NPI 1134121734
  Medicare reassignment NPD

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

{
    "created_epoch": "1423612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423612800000",
    "number": "1679964795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 SOUTH ST",
            "city": "NEW PROVIDENCE",
            "state": "NJ",
            "postal_code": "079742934",
            "telephone_number": "973-452-9078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 SOUTH ST",
            "city": "NEW PROVIDENCE",
            "state": "NJ",
            "postal_code": "079742934",
            "telephone_number": "973-452-9078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRC360, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-11",
        "last_updated": "2015-02-11",
        "status": "A",
        "authorized_official_last_name": "CAVAZOS",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-452-9078"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David S. Hoffman, M.D.,P.C.
• Dear Dental PC
• Kayla Delgado, LSW
• Laura Lynn Demaria, APN
• Arden Dooley
• Carolyn Driscoll, MS OTR
• Thomas Dwyer
• Dynamic Wellness Solutions
• Julie Dziedzic-Carroll, LCSW
• Kelly Jean Eberhardt, MD

• Geriatric Medicine (Family Medicine) Physician in New Providence, NJ
• Providers in New Providence, NJ by specialty
• Geriatric Medicine (Family Medicine) Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2015; 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.