Jack P Dimarco, M.D.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

25MA04166400 Issued in NJ

Practice address

1600 Haddon Ave
Room 122
Camden, NJ 08103-3101

Phone

(856) 757-3879

Fax

(856) 757-3760

NPI assigned

Jun 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 10

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1841234341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8505",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080020505",
            "telephone_number": "856-755-1616",
            "fax_number": "856-755-0098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 HADDON AVE",
            "address_2": "ROOM 122",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081033101",
            "telephone_number": "856-757-3879",
            "fax_number": "856-757-3760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMARCO",
        "first_name": "JACK",
        "middle_name": "P",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NJ",
            "license": "25MA04166400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENCE BCBS",
            "identifier": "484625",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "JS280",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH / KEYSTONE",
            "identifier": "0108561000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CCN",
            "identifier": "853002",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHCS",
            "identifier": "19071",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4197831",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "F01770E4",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "0301021001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON NJ HEALTH",
            "identifier": "1092688",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0348309",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patricia A. Digilio, RN, APN
• Paige Diguglielmo, PA-C
• Donnamarie Dillon, CRNA
• Andrea Lynne Dimaio, DO
• Mark Thomas Dimarcangelo, D.O.
• Glenn G Dimatteo, CRNA
• Tuan A Dinh, MD
• Vincent Dinh, CRNA
• Shantay Monique Dinks-Brown, D.O.
• Gregory Joseph Diorio, DO

• Physical Medicine & Rehabilitation Physician in Camden, NJ
• Providers in Camden, NJ by specialty
• Physical Medicine & Rehabilitation Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.