Active NPI
Louis Siciliano, MD
- Specialist
- Manahawkin, NJ
National Provider Identifier
1760487250
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 25MA06394800
- Practice address
- 1140 Route 72 W
Manahawkin, NJ 08050-2412 - Phone
- (609) 597-6011
- NPI assigned
- Jun 20, 2005
- 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 |
|---|---|---|---|---|
| Specialist | 174400000X | 25MA06394800 | NJ | Primary |
Addresses
Primary practice location
1140 Route 72 W
Manahawkin, NJ 08050-2412
Mailing address
66 West Gilbert St
Red Bank, NJ 07701
Phone (732) 212-0051
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7106904 | Medicaid | NJ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA06394800 | NJ | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Coastal Anesthesia Associates, PC | Specialist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Specialist
- Manahawkin, NJ
- NPI 1831193234
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119225600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1206662400000",
"number": "1760487250",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "66 WEST GILBERT ST",
"city": "RED BANK",
"state": "NJ",
"postal_code": "07701",
"telephone_number": "732-212-0051",
"fax_number": "732-212-0713"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1140 ROUTE 72 W",
"city": "MANAHAWKIN",
"state": "NJ",
"postal_code": "080502412",
"telephone_number": "609-597-6011"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SICILIANO",
"first_name": "LOUIS",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-06-20",
"last_updated": "2008-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NJ",
"license": "25MA06394800",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7106904",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Manahawkin, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.