Individual provider Active NPI

Tracy Smith-Dipalo, MD

  • Internal Medicine Physician
  • Pompton Plains, NJ
National Provider Identifier
1851371835
Registry record updated Sep 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
48219 Issued in NJ
Practice address
28 Jackson Ave
Pompton Plains, NJ 07444-1453
Phone
(973) 835-2575
Fax
(973) 835-0531
NPI assigned
Jan 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2007

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 48219 NJ Primary

Addresses

Primary practice location

28 Jackson Ave
Pompton Plains, NJ 07444-1453

Mailing address

28 Jackson Ave
Pompton Plains, NJ 07444-1453
Phone (973) 835-2575

Other identifiers 1

IdentifierTypeStateIssuer
7726805MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
48219NJMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189468800000",
    "number": "1851371835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 JACKSON AVE",
            "city": "POMPTON PLAINS",
            "state": "NJ",
            "postal_code": "074441453",
            "telephone_number": "973-835-2575",
            "fax_number": "973-835-0531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 JACKSON AVE",
            "city": "POMPTON PLAINS",
            "state": "NJ",
            "postal_code": "074441453",
            "telephone_number": "973-835-2575",
            "fax_number": "973-835-0531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH-DIPALO",
        "first_name": "TRACY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-18",
        "last_updated": "2007-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "48219",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7726805",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pompton Plains, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.