Individual provider Active NPI

Adam Zucconi

  • Family Medicine Physician
  • Vineland, NJ
National Provider Identifier
1770837833
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MB09355800 Issued in NJ
Practice address
352 S Delsea Dr Ste C
Vineland, NJ 08360-5306
Phone
(856) 690-1616
Fax
(856) 690-1089
NPI assigned
Oct 28, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NONE- PGY2 NJ
Family Medicine Physician 207Q00000X 25MB09355800 NJ Primary

Addresses

Primary practice location

352 S Delsea Dr Ste C
Vineland, NJ 08360-5306

Mailing address

352 S Delsea Dr Ste C
Vineland, NJ 08360-5306
Phone (856) 690-1616

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
I20141224000799 NJ Practitioner - Internal MedicinePractitioner - Sports Medicine 0840513859 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Sports Medicine
Education
West Virginia School of Osteopathic Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

298 S Delsea Dr
Vineland, NJ 08360-4568
Phone (856) 690-1616

Hospital & facility affiliations

  • Inspira Medical Center Vineland Hospital, Vineland, NJ, CCN 310032

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MB09355800NJMDFamily Medicine Physician
NONE- PGY2NJMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Excelcare Alliance, LLC Family Medicine CurrentSince Sep 5, 2017 Accepting new patients
Dendrinos Medical Associates, P.a. PastSince Sep 5, 2017 Accepting new patients

Locations

2020 E Chestnut Ave
Vineland, NJ 08361
Phone (856) 563-1600

Interoperability endpoints

  • Direct secure messaging: adam.zucconi@poasnj.eclinicaldirectplus.com
  • FHIR API: https://api.platform.athenahealth.com/12810/brand/1/csg/1/fhir/r4

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1351382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1770837833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "352 S DELSEA DR STE C",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083605306",
            "telephone_number": "856-690-1616",
            "fax_number": "856-690-1089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "352 S DELSEA DR STE C",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083605306",
            "telephone_number": "856-690-1616",
            "fax_number": "856-690-1089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZUCCONI",
        "first_name": "ADAM",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-28",
        "last_updated": "2023-03-07",
        "certification_date": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "NONE- PGY2",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MB09355800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vineland, NJ

Sources for this page

Verify at the official NPI Registry.