Cynthia R Prestigiacomo, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

25MA06407700 Issued in NJ

Practice address

80 Bloomfield Avenue
Second Floor
Caldwell, NJ 07006-5342

Phone

(973) 618-9990

Fax

(973) 618-9991

NPI assigned

Oct 4, 2006

Last updated

Nov 5, 2017By the provider in NPPES

Sex

Female

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 8

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Verona Pediatrics

  • Pediatrics Physician
  • Caldwell, NJ
  • NPI 1700032372
  NPD (past)

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509840000000",
    "number": "1730275207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "LB# 7550 PO BOX 95000",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191957550",
            "telephone_number": "844-362-1735",
            "fax_number": "973-290-7495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 BLOOMFIELD AVENUE",
            "address_2": "SECOND FLOOR",
            "city": "CALDWELL",
            "state": "NJ",
            "postal_code": "070065342",
            "telephone_number": "973-618-9990",
            "fax_number": "973-618-9991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRESTIGIACOMO",
        "first_name": "CYNTHIA",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2017-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA06407700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON MANAGED CARE",
            "identifier": "J7679",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5932171",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1466998",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "1K2417",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE",
            "identifier": "545631",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P410290",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "223685542",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "413844",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dimitry Polishchuk
• Salvatrice Rosalia Polizzotto, MSW, LCSW LLC
• Wendy R Pollack, LCSW
• Precision Vision
• Premier Family Medical, PC
• Prime Arthritis and Rheumatology Center LLC
• Princeton Behavioral Associates, LLC
• Professional Occupational & Physical Therapy, PLLC
• Professional Orthopedic and Sports Physical Therapy of NJ, LLC
• Penelope B. Prosperi, MSW

• Pediatrics Physician in Caldwell, NJ
• Providers in Caldwell, NJ by specialty
• Pediatrics Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2017; 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.

Verify at the official NPI Registry.