Anthony Prousi, DDS, MD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DS037334 Issued in PA

Practice address

1900 Mount Holly Road, BLDG 500
Burlington, NJ 08016

Phone

(609) 526-8650

Fax

(609) 526-8640

NPI assigned

Jul 14, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jun 30, 2017 through Jun 30, 2027

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Prousi Oral & Facial Surgery, LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Burlington Township, NJ
  • NPI 1154860120
  NPD (past) Authorized official

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

{
    "created_epoch": "1247529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1992934830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 MOUNT HOLLY ROAD, BLDG 500",
            "city": "BURLINGTON",
            "state": "NJ",
            "postal_code": "08016",
            "telephone_number": "609-526-8650",
            "fax_number": "609-526-8640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 MOUNT HOLLY ROAD, BLDG 500",
            "city": "BURLINGTON",
            "state": "NJ",
            "postal_code": "08016",
            "telephone_number": "609-526-8650",
            "fax_number": "609-526-8640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROUSI",
        "first_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "DDS, MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-07-14",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "DI02541600",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "PA",
            "license": "DS037334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Pratola, LPN
• Prince Association for the Developmentally Disabled, Inc
• Annalise Pritchett, PT, DPT, OCS
• Mackayla Renee Probasco, PA-C
• Debbra Prosperi, LPN
• Michele Renee Pryor-Andrews, LPN
• Anna Pukajlo-Kwasniewska, PT
• Purpose Human Services
• Danielle L Puzio, BS
• Quality Healthcare Services, LLC

• Oral and Maxillofacial Surgery (Dentist) in Burlington, NJ
• Providers in Burlington, 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 21, 2022; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.