Individual provider Active NPI

Bernadette Marion Cracchiolo, M.D.

  • Gynecologic Oncology Physician
  • Newark, NJ
National Provider Identifier
1891721668
Registry record updated Jan 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecologic Oncology PhysicianTaxonomy code 207VX0201X
License
25MA06645100 Issued in NJ
Practice address
140 Bergen St
Acc Level C
Newark, NJ 07103-2425
Phone
(973) 972-2700
Fax
(973) 972-2739
NPI assigned
Jun 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecologic Oncology Physician 207VX0201X 25MA06645100 NJ Primary

Addresses

Primary practice location

140 Bergen St
Acc Level C
Newark, NJ 07103-2425

Mailing address

30 Bergen St
Admc 12 1205
Newark, NJ 07107-3000

Other identifiers 1

IdentifierTypeStateIssuer
7404204MedicaidNJ

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bcracchiolo7188@direct.uhnj.org Direct University Hospital

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
I20110215000039 NJ Practitioner - Gynecological OncologyPractitioner - Obstetrics/GynecologyPractitioner - Hospice/Palliative Care 0042490609 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA06645100NJMDGynecologic Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Physician Associates of New Jersey Inc CurrentSince Dec 16, 1997 Accepting new patients
University Physician Associates of New Jersey Inc CurrentSince Dec 16, 1997 Accepting new patients
Saint Peter'S Healthcare System Physician Associates CurrentSince May 6, 2014 Accepting new patients

Locations

240 Easton Ave
Fl 3
New Brunswick, NJ 08901
Phone (732) 565-5453

140 Bergen St
Newark, NJ 07103
Phone (973) 972-0320

140 Bergen St
#C
Newark, NJ 07103
Phone (973) 972-2700

30 Bergen St
#12
Newark, NJ 07107
Phone (973) 972-0037

150 Bergen St
Newark, NJ 07103
Phone (973) 972-6056

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643068800000",
    "number": "1891721668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 BERGEN ST",
            "address_2": "ADMC 12 1205",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071073000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 BERGEN ST",
            "address_2": "ACC LEVEL C",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032425",
            "telephone_number": "973-972-2700",
            "fax_number": "973-972-2739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRACCHIOLO",
        "first_name": "BERNADETTE",
        "middle_name": "MARION",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-24",
        "last_updated": "2022-01-25",
        "certification_date": "2022-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "NJ",
            "license": "25MA06645100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7404204",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bcracchiolo7188@direct.uhnj.org",
            "affiliation": "Y",
            "affiliationName": "University Hospital",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "150 Bergen St",
            "city": "Newark",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "071032496",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.