Individual provider Active NPI

John C Scolamiero, MD

  • Internal Medicine Physician
  • East Rutherford, NJ
National Provider Identifier
1780766600
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA04872600 Issued in NJ
Practice address
245 Park Avenue
East Rutherford, NJ 07073
Phone
(201) 939-7161
Fax
(201) 939-4053
NPI assigned
Oct 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MA04872600 NJ Primary

Addresses

Primary practice location

245 Park Avenue
East Rutherford, NJ 07073

Mailing address

245 Park Avenue
East Rutherford, NJ 07073
Phone (973) 882-3545

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
I20060118000452 NJ Practitioner - Internal Medicine 9032133996 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Consensus Medical Group LLCGroup PAC ID 2961748181, 138 clinicians

Practice addresses (Care Compare)

245 Park Ave
East Rutherford, NJ 07073-1918
Phone (201) 939-7161

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA04872600NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Med-Care of Fairfield, Inc. Internal Medicine CurrentSince Jan 1, 1989 Accepting new patients
Consensus Medical Group LLC Internal Medicine CurrentSince Apr 11, 2023 Accepting new patients
Med-Care of East Hanover, Inc. Internal Medicine PastSince Jul 3, 2010 Accepting new patients
Skylands Medical Group, P.a. Internal Medicine Past Accepting new patients

Locations

245 Park Ave
East Rutherford, NJ 07073
Phone (201) 939-7161

150 Fairfield Rd
Fairfield, NJ 07004
Phone (973) 227-0020

706 Bergen Ave
Ste 2
Jersey City, NJ 07306
Phone (201) 464-8888

94 Old Short Hills Rd
Livingston, NJ 07039
Phone (973) 322-5400

Organizations & group practices 5

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.

Hospital & facility affiliations 2

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": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780766600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 PARK AVENUE",
            "city": "EAST RUTHERFORD",
            "state": "NJ",
            "postal_code": "07073",
            "telephone_number": "973-882-3545",
            "fax_number": "973-882-0457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 PARK AVENUE",
            "city": "EAST RUTHERFORD",
            "state": "NJ",
            "postal_code": "07073",
            "telephone_number": "201-939-7161",
            "fax_number": "201-939-4053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOLAMIERO",
        "first_name": "JOHN",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA04872600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Rutherford, NJ

Sources for this page

Verify at the official NPI Registry.