Individual provider Active NPI

John A Coccaro, MD

  • Emergency Medicine Physician
  • Bayonne, NJ
National Provider Identifier
1841213121
Registry record updated Jun 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MA52666 Issued in NJ
Practice address
29 E 29TH St
Bayonne, NJ 07002-4654
Phone
(856) 616-8100
NPI assigned
Jul 26, 2006
Last updated
Jun 9, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MA52666 NJ Primary

Addresses

Primary practice location

29 E 29TH St
Bayonne, NJ 07002-4654

Mailing address

PO Box 5075
Cherry Hill, NJ 08034-5075

Other identifiers 2

IdentifierTypeStateIssuer
P00477077OtherNJMEDICARE RAILROAD CARRIER
20318OtherNJUHP NON PAR #

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
I20080409000052 NJ Practitioner - Emergency Medicine 4789691924 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA52666NJMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ijkg Opco LLC Current Accepting new patients
Garden State Healthcare Associates, LLC Emergency Medicine CurrentSince Sep 1, 2009 Accepting new patients

Locations

29 E 29th St
Bayonne, NJ 07002
Phone (201) 585-5000

308 Willow Ave
Hoboken, NJ 07030
Phone (201) 418-1574

Interoperability endpoints

  • Direct secure messaging: john.coccaro@direct.bayonnemedicalcenter.md

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244505600000",
    "number": "1841213121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5075",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080345075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 E 29TH ST",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070024654",
            "telephone_number": "856-616-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COCCARO",
        "first_name": "JOHN",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2009-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "MA52666",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD CARRIER",
            "identifier": "P00477077",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHP NON PAR #",
            "identifier": "20318",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayonne, NJ

Sources for this page

Verify at the official NPI Registry.