Organization Active NPI

D a Benedetto MD PA

  • Ophthalmology Physician
  • Bayonne, NJ
National Provider Identifier
1770640294
Registry record updated Feb 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
25MA3211800 Issued in NJ
Legal business name
D A BENEDETTO MD PA
Practice address
124 Avenue B
Bayonne, NJ 07002
Phone
(201) 436-1150
Fax
(201) 436-0161
NPI assigned
Jan 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2011

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

Authorized official

Name
Dominick A Benedetto, M.D
Title
President
Phone
(201) 436-1150

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X 25MA3211800 NJ Primary

Addresses

Primary practice location

124 Avenue B
Bayonne, NJ 07002

Mailing address

124 Avenue B
Bayonne, NJ 07002
Phone (201) 436-1150

National Provider Directory

National Provider Directory

Locations

124 Avenue B
Bayonne, NJ 07002
Phone (201) 436-1150

170 Kinnelon Rd
Kinnelon, NJ 07405
Phone (201) 436-1150

111 Madison Ave
Ste 301
Morristown, NJ 07960
Phone (973) 267-1197

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": "1167782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297036800000",
    "number": "1770640294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 AVENUE B",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "07002",
            "telephone_number": "201-436-1150",
            "fax_number": "201-436-0161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 AVENUE B",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "07002",
            "telephone_number": "201-436-1150",
            "fax_number": "201-436-0161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "D A BENEDETTO MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-03",
        "last_updated": "2011-02-07",
        "status": "A",
        "authorized_official_last_name": "BENEDETTO",
        "authorized_official_first_name": "DOMINICK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-436-1150",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "NJ",
            "license": "25MA3211800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayonne, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.