Individual provider Active NPI

Joseph Thomas Vitale, M.D.

  • Family Medicine Physician
  • Woodland Park, NJ
National Provider Identifier
1780965905
Registry record updated Sep 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MA09281500 Issued in NJ
Practice address
1031 McBride Ave
Suite D109
Woodland Park, NJ 07424-2559
Phone
(973) 785-4020
NPI assigned
Sep 1, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 25MA09281500 NJ Primary

Addresses

Primary practice location

1031 McBride Ave
Suite D109
Woodland Park, NJ 07424-2559

Mailing address

1031 McBride Ave
Suite D109
Woodland Park, NJ 07424-2559
Phone (973) 785-4020

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
I20130918000778 NJ Practitioner - Family Practice 1355585019 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
West Paterson Family Medical Center, PAGroup PAC ID 4880766922, 4 clinicians

Practice addresses (Care Compare)

1031 McBride Ave
Suite D109
Woodland Park, NJ 07424-2568
Phone (973) 785-4020

Hospital & facility affiliations

  • Adoration Home Health Home health agency, Clifton, NJ, CCN 317017
  • Visiting Health Services of New Jersey Home health agency, Woodland Park, NJ, CCN 317058
  • Valley Home Care Inc. Home health agency, Paramus, NJ, CCN 317008
  • St Joseph'S University Medical Center Inc Hospital, Paterson, NJ, CCN 310019
  • Chilton Medical Center Hospital, Pompton Plains, NJ, CCN 310017

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
West Paterson Family Medical Center,PA CurrentSince Aug 1, 2013 Accepting new patients
St Josephs University Medical Center Inc. Past Accepting new patients

Locations

999 McBride Ave
Ste B202
Woodland Park, NJ 07424
Phone (973) 256-7599

1031 McBride Ave
Ste D109
Woodland Park, NJ 07424
Phone (973) 785-4020

Organizations & group practices 2

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 6

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": "1314835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378425600000",
    "number": "1780965905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1031 MCBRIDE AVE",
            "address_2": "SUITE D109",
            "city": "WOODLAND PARK",
            "state": "NJ",
            "postal_code": "074242559",
            "telephone_number": "973-785-4020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1031 MCBRIDE AVE",
            "address_2": "SUITE D109",
            "city": "WOODLAND PARK",
            "state": "NJ",
            "postal_code": "074242559",
            "telephone_number": "973-785-4020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VITALE",
        "first_name": "JOSEPH",
        "middle_name": "THOMAS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-01",
        "last_updated": "2013-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA09281500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodland Park, NJ

Sources for this page

Verify at the official NPI Registry.