Amerigo J Fedeli, DMD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DI 19676 Issued in NJ

Practice address

135 Jackson Rd
Laurel Professional Center - Suite a
Medford, NJ 08055-9231

Phone

(609) 654-1300

Fax

(609) 654-0040

NPI assigned

Jul 19, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Maxillofacial Surgery

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• South Jersey Oral & Maxillofacial Surgeons, LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Medford, NJ
  • NPI 1447272562
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1922027820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 JACKSON RD",
            "address_2": "LAUREL PROFESSIONAL CENTER - SUITE A",
            "city": "MEDFORD",
            "state": "NJ",
            "postal_code": "080559231",
            "telephone_number": "609-654-1300",
            "fax_number": "609-654-0040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 JACKSON RD",
            "address_2": "LAUREL PROFESSIONAL CENTER - SUITE A",
            "city": "MEDFORD",
            "state": "NJ",
            "postal_code": "080559231",
            "telephone_number": "609-654-1300",
            "fax_number": "609-654-0040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEDELI",
        "first_name": "AMERIGO",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NJ",
            "license": "DI 19676",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6970303",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Franck Euksuzian, D.M.D.
• Sarkis Euksuzian, D.M.D., P.A.
• Eyecare Physicians & Surgeons of NJ
• Kathryn Farrell, APN
• Terry L Fazio, NP
• Brian Feingold
• Felicia R. Neubauer, M.S.W.,L.C.S.W.,L.L.C.
• Robin Maxwell Fields, RPH
• Henry Wilson Finger, D.D.S.
• Nicole Paulina Fisher, MA, LAC

• Oral and Maxillofacial Surgery (Dentist) in Medford, NJ
• Providers in Medford, NJ by specialty
• Oral and Maxillofacial Surgery (Dentist) in New Jersey

• 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; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.