Active NPI
Jerald P Vizzone, D.O.
- Orthopaedic Surgery Physician
- Montclair, NJ
National Provider Identifier
1861617623
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- 25MB06085400
- Practice address
- 242 Claremont Ave
Montclair, NJ 07042-2812 - Phone
- (973) 783-1444
- Fax
- (973) 783-7755
- NPI assigned
- Apr 16, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 25MB06085400 | NJ | Primary |
Addresses
Primary practice location
242 Claremont Ave
Montclair, NJ 07042-2812
Mailing address
242 Claremont Ave
Montclair, NJ 07042-2812
Phone (973) 783-1444
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 1, 2024 through Apr 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
Interoperability endpoints
- jvizzone253315@epicdirect.rwjbh.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176681600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1861617623",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "242 CLAREMONT AVE",
"city": "MONTCLAIR",
"state": "NJ",
"postal_code": "070422812",
"telephone_number": "973-783-1444",
"fax_number": "973-783-7755"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "242 CLAREMONT AVE",
"city": "MONTCLAIR",
"state": "NJ",
"postal_code": "070422812",
"telephone_number": "973-783-1444",
"fax_number": "973-783-7755"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VIZZONE",
"first_name": "JERALD",
"middle_name": "P",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "NJ",
"license": "25MB06085400",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Montclair, NJ
Sources for this page
- 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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.