Individual provider Active NPI

Jared Gittleman, D.M.D.

  • Dentist
  • Prospect Park, PA
National Provider Identifier
1932558624
Registry record updated Jun 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DS040782 Issued in PA
Practice address
1319 Lincoln Ave
Prospect Park, PA 19076-1216
Phone
(610) 532-5008
NPI assigned
Jun 3, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DS040782 PA Primary
Dentist 122300000X 22DI02643000 NJ

Addresses

Primary practice location

1319 Lincoln Ave
Prospect Park, PA 19076-1216

Mailing address

1319 Lincoln Ave PO Box 254
Prospect Park, PA 19076-1216
Phone (610) 532-5008

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
22DI02643000NJMDDentist
DS040782PAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Rapozafamily Dentistry Dentist 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1464912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466640000000",
    "number": "1932558624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1319 LINCOLN AVE PO BOX 254",
            "city": "PROSPECT PARK",
            "state": "PA",
            "postal_code": "190761216",
            "telephone_number": "610-532-5008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1319 LINCOLN AVE",
            "city": "PROSPECT PARK",
            "state": "PA",
            "postal_code": "190761216",
            "telephone_number": "610-532-5008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GITTLEMAN",
        "first_name": "JARED",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-03",
        "last_updated": "2016-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS040782",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI02643000",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prospect Park, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.