NPIMap

Organization Active NPI

Dimarino-Kroop-Prieto Gastro-Intestinal Associates,PA

  • Specialist
  • Woodbury, NJ
National Provider Identifier
1962422295
Registry record updated Aug 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MA23137 Issued in NJ
Legal business name
DIMARINO-KROOP-PRIETO GASTRO-INTESTINAL ASSOCIATES,PA
Practice address
26 East Red Bank Ave
Woodbury, NJ 08096-1630
Phone
(856) 848-4464
Fax
(856) 848-7023
NPI assigned
Jul 20, 2006
Last updated
Aug 18, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2009

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

Authorized official

Name
Dr. Anthony James Dimarino Jr., MDNPI 1780643775
Title
President of Corporation
Phone
(856) 848-4464

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
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X MA23137 NJ Primary

Addresses

Primary practice location

26 East Red Bank Ave
Woodbury, NJ 08096-1630

Mailing address

26 East Red Bank Ave
Woodbury, NJ 08096-1630
Phone (856) 848-4464

Other identifiers 1

IdentifierTypeStateIssuer
1996401MedicaidNJ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040220001101 NJ Part B Supplier - Clinic/Group Practice 8325933906 Receives reassigned benefits from 29 practitioners
1 other NPI on this enrollment
Practice locations: Mullica Hill, NJ; Woodbury, NJ

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Dimarino Kroop Gi Asssc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 29

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1250553600000",
    "number": "1962422295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 EAST RED BANK AVE",
            "city": "WOODBURY",
            "state": "NJ",
            "postal_code": "080961630",
            "telephone_number": "856-848-4464",
            "fax_number": "856-848-7023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 EAST RED BANK AVE",
            "city": "WOODBURY",
            "state": "NJ",
            "postal_code": "080961630",
            "telephone_number": "856-848-4464",
            "fax_number": "856-848-7023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIMARINO-KROOP-PRIETO GASTRO-INTESTINAL ASSOCIATES,PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-20",
        "last_updated": "2009-08-18",
        "status": "A",
        "authorized_official_last_name": "DIMARINO",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT OF CORPORATION",
        "authorized_official_telephone_number": "856-848-4464",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NJ",
            "license": "MA23137",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1996401",
            "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 Aug 18, 2009; 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.