Organization Active NPI

Ligresti Dermatology Associates PA

  • Dermatology Physician
  • Belleville, NJ
National Provider Identifier
1710031919
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
MA40615 Issued in NJ
Legal business name
LIGRESTI DERMATOLOGY ASSOCIATES PA
Practice address
36 Newark Avenue
Suite 120
Belleville, NJ 07109-4120
Phone
(973) 759-6569
Fax
(973) 759-2562
NPI assigned
Jan 23, 2007
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
Dominick Joseph Ligresti, MDNPI 1598780991
Title
Owner Ligresti Dermatology Associat
Phone
(973) 759-6569

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X MA40615 NJ Primary

Addresses

Primary practice location

36 Newark Avenue
Suite 120
Belleville, NJ 07109-4120

Mailing address

36 Newark Avenue
Suite 120
Belleville, NJ 07109-4120
Phone (973) 759-6569

Other names 1

  • Dominick J Ligresti MD Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050720000322 NJ Part B Supplier - Clinic/Group Practice 7012944267 Receives reassigned benefits from 1 practitioner
Practice locations: Nutley, NJ

National Provider Directory

National Provider Directory

Locations

36 Newark Ave
Ste 120
Belleville, NJ 07109
Phone (973) 302-7551

175 Franklin Ave
Ste 103
Nutley, NJ 07110
Phone (973) 661-1833

175 Franklin Ave
Nutley, NJ 07110
Phone (973) 661-5200

Practitioners & affiliated clinicians

Practitioners 2

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": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1710031919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 NEWARK AVENUE",
            "address_2": "SUITE 120",
            "city": "BELLEVILLE",
            "state": "NJ",
            "postal_code": "071094120",
            "telephone_number": "973-759-6569",
            "fax_number": "973-759-2562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 NEWARK AVENUE",
            "address_2": "SUITE 120",
            "city": "BELLEVILLE",
            "state": "NJ",
            "postal_code": "071094120",
            "telephone_number": "973-759-6569",
            "fax_number": "973-759-2562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGRESTI DERMATOLOGY ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LIGRESTI",
        "authorized_official_first_name": "DOMINICK",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER LIGRESTI DERMATOLOGY ASSOCIAT",
        "authorized_official_telephone_number": "973-759-6569",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "NJ",
            "license": "MA40615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dominick J Ligresti MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Belleville, 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.