Individual provider Active NPI

Anthony J Squillaro, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Brick, NJ
National Provider Identifier
1740289875
Registry record updated Aug 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
MA49021 Issued in NJ
Practice address
525 Jack Martin Blvd Ste a
Brick, NJ 08724-7737
Phone
(732) 374-9217
Fax
(732) 974-1246
NPI assigned
Jul 20, 2005
Last updated
Aug 19, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X MA49021 NJ Primary

Addresses

Primary practice location

525 Jack Martin Blvd Ste a
Brick, NJ 08724-7737

Mailing address

525 Jack Martin Blvd Ste a
Brick, NJ 08724-7737
Phone (732) 374-9217

Other identifiers 1

IdentifierTypeStateIssuer
1566105MedicaidNJ

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050414000246 NJ Practitioner - Thoracic SurgeryPractitioner - Vascular Surgery 8426095126 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Thoracic SurgeryAlso: Vascular Surgery
Education
Rutgers New Jersey Medical School, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New Jersey Medical Services Group LLCGroup PAC ID 4486878626, 27 clinicians

Practice addresses (Care Compare)

1000 Atrium Way
Suite 103
Mount Laurel, NJ 08054-3903
Phone (866) 607-2308

200 Metroplex Dr
Suite 410
Edison, NJ 08817-2600
Phone (866) 607-2308

34 Mountain Blvd
Suite 203
Warren, NJ 07059-2640
Phone (866) 607-2308

385 Prospect Ave
Suite 316
Hackensack, NJ 07601-2570
Phone (248) 847-4925

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal936

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MA49021NJMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New Jersey Medical Services Group, LLC CurrentSince Oct 3, 2022 Accepting new patients
Eastern Monmouth Physical Therapy LLC PastSince Jan 8, 2003 Accepting new patients
Pottstown Clinic Company LLC Past Accepting new patients

Locations

400 Broadacres Dr
Ste 140
Bloomfield, NJ 07003

525 Jack Martin Blvd
Ste 200
Brick, NJ 08724
Phone (732) 836-9669

200 Metroplex Dr
Ste 410
Edison, NJ 08817

83 Hanover Rd
Ste 230
Florham Park, NJ 07932

385 Prospect Ave
Ste 316
Hackensack, NJ 07601
Phone (201) 581-0773

475 County Road 520
Ste 104
Marlboro, NJ 07746

1000 Atrium Way
Ste 103
Mount Laurel, NJ 08054
Phone (856) 235-9995

855 Lehigh Ave
Ste 201
Union, NJ 07083

34 Mountain Blvd
Ste A203
Warren, NJ 07059

1680 Route 23
Ste 330
Wayne, NJ 07470

34 Marconi St
Ste 260
Bronx, NY 10461
Phone (668) 607-2308

111 E 57th St
Rm 202
New York, NY 10022
Phone (646) 921-6266

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787097600000",
    "number": "1740289875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 JACK MARTIN BLVD STE A",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087247737",
            "telephone_number": "732-374-9217",
            "fax_number": "732-974-1246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 JACK MARTIN BLVD STE A",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087247737",
            "telephone_number": "732-374-9217",
            "fax_number": "732-974-1246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SQUILLARO",
        "first_name": "ANTHONY",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-20",
        "last_updated": "2026-08-19",
        "certification_date": "2026-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "NJ",
            "license": "MA49021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1566105",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brick, NJ

Sources for this page

Verify at the official NPI Registry.