NPIMap

Individual provider Active NPI

John C Daly, MD

  • Internal Medicine Physician
  • West Deptford, NJ
National Provider Identifier
1801835905
Registry record updated Mar 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA07143300 Issued in NJ
Practice address
100 W Red Bank Ave
West Deptford, NJ 08096-3407
Phone
(856) 292-8216
Fax
(856) 848-3011
NPI assigned
Jun 5, 2006
Last updated
Mar 12, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2016

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 25MA07143300 NJ Primary

Addresses

Primary practice location

100 W Red Bank Ave
West Deptford, NJ 08096-3407

Mailing address

PO Box 65
Collingswood, NJ 08108-0065
Phone (856) 292-8216

Other identifiers 1

IdentifierTypeStateIssuer
8421803MedicaidNJ

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
I20080403000225 NJ Practitioner - Internal Medicine 3971680778 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Rutgers New Jersey Medical School, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Seto Medical Providers,LLCGroup PAC ID 6507943305, 2 clinicians

Practice addresses (Care Compare)

100 W Red Bank Ave
West Deptford, NJ 08096-3407
Phone (856) 292-8216

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA07143300NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Seto Medical Providers,LLC Internal Medicine CurrentSince Feb 1, 2008 Accepting new patients

Locations

100 Red Bank Ave
West Deptford, NJ 08096
Phone (856) 241-3311

Organizations & group practices 1

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 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457740800000",
    "number": "1801835905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 65",
            "city": "COLLINGSWOOD",
            "state": "NJ",
            "postal_code": "081080065",
            "telephone_number": "856-292-8216",
            "fax_number": "856-848-3011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W RED BANK AVE",
            "city": "WEST DEPTFORD",
            "state": "NJ",
            "postal_code": "080963407",
            "telephone_number": "856-292-8216",
            "fax_number": "856-848-3011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALY",
        "first_name": "JOHN",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-05",
        "last_updated": "2016-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA07143300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8421803",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Deptford, NJ

Sources for this page

Verify at the official NPI Registry.