Individual provider Active NPI

Rodolfo Colaco, M.D.

  • Surgery Physician
  • Elizabeth, NJ
National Provider Identifier
1912964537
Registry record updated Mar 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
25MA04519200 Issued in NJ
Practice address
431 Elmora Ave
Elizabeth, NJ 07208-1576
Phone
(908) 353-4177
Fax
(908) 353-7201
NPI assigned
Apr 27, 2006
Last updated
Mar 4, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2022

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 25MA04519200 NJ
Internal Medicine Physician 207R00000X 25MA04519200 NJ
Surgery Physician 208600000X 25MA04519200 NJ Primary
Surgery of the Hand (Surgery) Physician 2086S0105X 25MA04519200 NJ
Vascular Surgery Physician 2086S0129X 25MA04519200 NJ
Colon & Rectal Surgery Physician 208C00000X 25MA04519200 NJ

Addresses

Primary practice location

431 Elmora Ave
Elizabeth, NJ 07208-1576

Mailing address

431 Elmora Ave
Elizabeth, NJ 07208-1576
Phone (908) 353-4177

Other identifiers 1

IdentifierTypeStateIssuer
0359203MedicaidNJ

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
I20100824000390 NJ Practitioner - General SurgeryPractitioner - General PracticePractitioner - Colorectal Surgery (Proctology) 8426172750 Practice locations: Elizabeth, NJ

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Colorectal Surgery (Proctology), General Practice
Education
Other, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

431 Elmora Ave
Elizabeth, NJ 07208-1578
Phone (908) 353-4177

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)23
Mastectomy1-10
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA04519200NJMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Trinitas Physicians Practice, LLC Internal Medicine Past Accepting new patients

Organizations & group practices 1

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

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646352000000",
    "number": "1912964537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "431 ELMORA AVE",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072081576",
            "telephone_number": "908-353-4177",
            "fax_number": "908-353-7201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "431 ELMORA AVE",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072081576",
            "telephone_number": "908-353-4177",
            "fax_number": "908-353-7201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLACO",
        "first_name": "RODOLFO",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2022-03-04",
        "certification_date": "2022-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NJ",
            "license": "25MA04519200",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA04519200",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NJ",
            "license": "25MA04519200",
            "primary": true
        },
        {
            "code": "2086S0105X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgery of the Hand",
            "state": "NJ",
            "license": "25MA04519200",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NJ",
            "license": "25MA04519200",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "NJ",
            "license": "25MA04519200",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0359203",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabeth, NJ

Sources for this page

Verify at the official NPI Registry.