Active NPI
Eugene L Desalvo, MD
- Urology Physician
- Freehold, NJ
National Provider Identifier
1699757898
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- MA31852
- Practice address
- 515 Iron Bridge Rd
Freehold, NJ 07728-5300 - Phone
- (732) 780-3434
- Fax
- (732) 780-9334
- NPI assigned
- Nov 15, 2005
- Last updated
- Jun 29, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | MA31852 | NJ | Primary |
Addresses
Primary practice location
515 Iron Bridge Rd
Freehold, NJ 07728-5300
Mailing address
515 Iron Bridge Rd
Freehold, NJ 07728-5300
Phone (732) 780-3434
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3051200 | Medicaid | NJ |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160307002520 | NJ | Order and Referring Only - Urology | 5496930968 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA31852 | NJ | MD | Urology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132012800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1277769600000",
"number": "1699757898",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "515 IRON BRIDGE RD",
"city": "FREEHOLD",
"state": "NJ",
"postal_code": "077285300",
"telephone_number": "732-780-3434",
"fax_number": "732-780-9334"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "515 IRON BRIDGE RD",
"city": "FREEHOLD",
"state": "NJ",
"postal_code": "077285300",
"telephone_number": "732-780-3434",
"fax_number": "732-780-9334"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DESALVO",
"first_name": "EUGENE",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-11-15",
"last_updated": "2010-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "NJ",
"license": "MA31852",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3051200",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Freehold, NJ
- Dermatology Partners
- Alicia Raquel Dermer, MD
- Dermone Dermatology Associates of the Garden State, PC
- Rajen Uday Desai, M.D.
- Alexandria Noelle Desalvatore, OTR
- Poornima Deshmukh, M.D.
- Alix Detullio, APN
- John P Detullio, M.D., F.C.C.P.
- Development 4 Individuals With Disability
- Devereux NJ Reach Treatment Home
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.