Organization Active NPI

David D Carrozzino DPM, PC

  • Podiatrist
  • Woodbury, NJ
National Provider Identifier
1902845860
Registry record updated Jul 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
MDO2048 Issued in NJ
Legal business name
DAVID D CARROZZINO DPM, PC
Practice address
158 Delaware St
Woodbury, NJ 08096-5921
Phone
(856) 845-5515
Fax
(856) 853-6890
NPI assigned
Jun 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2010

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

Authorized official

Name
Dr. David Dominick Carrozzino, DPMNPI 1477552362
Title
Owner/Doctor
Phone
(856) 845-5515

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X MDO2048 NJ Primary

Addresses

Primary practice location

158 Delaware St
Woodbury, NJ 08096-5921

Mailing address

158 Delaware St
Woodbury, NJ 08096-5921
Phone (856) 845-5515

Other identifiers 2

IdentifierTypeStateIssuer
1687369OtherNJAMERIHEALTH PPO GROUP NUM
762090OtherNJBLUE SHIELD GROUP NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120214000378 NJ Part B Supplier - Clinic/Group Practice 6507023991 Receives reassigned benefits from 2 practitioners
Practice locations: Woodbury, NJ

National Provider Directory

National Provider Directory

Locations

158 Delaware St
Woodbury, NJ 08096
Phone (609) 845-5515

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279584000000",
    "number": "1902845860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "158 DELAWARE ST",
            "city": "WOODBURY",
            "state": "NJ",
            "postal_code": "080965921",
            "telephone_number": "856-845-5515",
            "fax_number": "856-853-6890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "158 DELAWARE ST",
            "city": "WOODBURY",
            "state": "NJ",
            "postal_code": "080965921",
            "telephone_number": "856-845-5515",
            "fax_number": "856-853-6890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID D CARROZZINO DPM, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-06",
        "last_updated": "2010-07-20",
        "status": "A",
        "authorized_official_last_name": "CARROZZINO",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "DOMINICK",
        "authorized_official_title_or_position": "OWNER/DOCTOR",
        "authorized_official_telephone_number": "856-845-5515",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "NJ",
            "license": "MDO2048",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH PPO GROUP NUM",
            "identifier": "1687369",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD GROUP NUMBER",
            "identifier": "762090",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.