Jerome R. Pietras, D.O.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

25MB02740200 Issued in NJ

Practice address

570 Egg Harbor Rd
Ste a-1
Sewell, NJ 08080-2359

Phone

(856) 582-9645

Fax

(856) 218-3030

NPI assigned

Jun 12, 2006

Last updated

May 16, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337126400000",
    "number": "1699717637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "570 EGG HARBOR RD",
            "address_2": "STE A-1",
            "city": "SEWELL",
            "state": "NJ",
            "postal_code": "080802359",
            "telephone_number": "856-582-9645",
            "fax_number": "856-218-3030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "570 EGG HARBOR RD",
            "address_2": "STE A-1",
            "city": "SEWELL",
            "state": "NJ",
            "postal_code": "080802359",
            "telephone_number": "856-582-9645",
            "fax_number": "856-218-3030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIETRAS",
        "first_name": "JEROME",
        "middle_name": "R.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2012-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NJ",
            "license": "25MB02740200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "203770",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thuyanh Ngoc Phan, N.P
• Pharmcierge
• Philadelphia Vamc
• Phillips Chiropractic Centre
• David Phillips, D.C.
• Amanda Courtney Pinkerton, OD
• Heather Pitman, OTR/L
• Alisa B Pittaluga, OT
• Lauren Pluchino, L.C.S.W.
• Peter A. Plumeri, D.O., D.A.C.P.

• Urology Physician in Sewell, NJ
• Providers in Sewell, NJ by specialty
• Urology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.