NPIMap

Individual provider Active NPI

Michael E Monte Carlo, DO

  • Family Medicine Physician
  • Woodbury, NJ
National Provider Identifier
1790909760
Registry record updated Nov 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MB08173000 Issued in NJ
Practice address
17 W Red Bank Ave Ste 201
Woodbury, NJ 08096-1630
Phone
(856) 536-1515
NPI assigned
Apr 12, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25MB08173000 NJ Primary

Addresses

Primary practice location

17 W Red Bank Ave Ste 201
Woodbury, NJ 08096-1630

Mailing address

1 Federal St # 200
Camden, NJ 08103-1088
Phone (856) 356-4924

Other practice location 1

159 S Broad St
Woodbury, NJ 08096-2410
Phone (844) 542-2273

Other practice location 2

165 Princeton Ave
West Deptford, NJ 08096-3123
Phone (844) 542-2273

Other identifiers 1

IdentifierTypeStateIssuer
0221171MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071009000636 NJ Practitioner - Family Practice 4789779570 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cooper Care Alliance, PCGroup PAC ID 5890110563, 118 clinicians

Practice addresses (Care Compare)

1 Cooper PLZ
Camden, NJ 08103-1461
Phone (856) 342-2627

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.52 of 100Reported as apm
Quality
81.58
Promoting interoperability
99.4
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MB08173000NJMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cooper Care Alliance, PC CurrentSince Nov 1, 2020 Accepting new patients
Family Physicians at Burlington Family Medicine Past Accepting new patients
Kennedy Medical Group Practice, P.C. Family Medicine PastSince Jun 15, 2021 Accepting new patients
The Cooper Health System Past Accepting new patients

Locations

1816 Route 541
Ste 102
Burlington, NJ 08016
Phone (609) 747-0870

1 Cooper Plz
Camden, NJ 08103
Phone (856) 342-2425

901 Route 168
Ste 210
Turnersville, NJ 08012
Phone (856) 227-1221

17 W Red Bank Ave
Ste 201
Woodbury, NJ 08096
Phone (856) 845-5220

Interoperability endpoints

  • Direct secure messaging: mmontecarlo36650@direct.cooperhealth.edu

Organizations & group practices 4

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 11

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": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605484800000",
    "number": "1790909760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FEDERAL ST # 200",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031088",
            "telephone_number": "856-356-4924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 W RED BANK AVE STE 201",
            "city": "WOODBURY",
            "state": "NJ",
            "postal_code": "080961630",
            "telephone_number": "856-536-1515"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "159 S Broad St",
            "address_purpose": "LOCATION",
            "city": "Woodbury",
            "state": "NJ",
            "postal_code": "080962410",
            "country_code": "US",
            "telephone_number": "844-542-2273",
            "fax_number": "856-384-0218",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "165 Princeton Ave",
            "address_purpose": "LOCATION",
            "city": "West Deptford",
            "state": "NJ",
            "postal_code": "080963123",
            "country_code": "US",
            "telephone_number": "844-542-2273",
            "fax_number": "856-384-0218",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONTE CARLO",
        "first_name": "MICHAEL",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-12",
        "last_updated": "2020-11-16",
        "certification_date": "2020-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MB08173000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0221171",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, NJ

Sources for this page

Verify at the official NPI Registry.