DR. JOHN MICHAEL PELLEGRINO (NPI# 1730254053) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730254053 |
| Entity Type | Individual |
| Full Name | DR. JOHN MICHAEL PELLEGRINO |
| Credential | MD |
| Practice Address |
459 Jack Martin Blvd Brick NJ 08724-7724 |
| Practice Telephone | 7324584600 |
| Practice Fax Number | 7324583885 |
| Mailing Telephone | 7324584600 |
| Mailing Fax Number | 7324583885 |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2013-06-25 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086X0206X |
Surgery Specialization: Surgical Oncology |
25MA05283200 | NJ | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932107596 | John Arthur Pellegrino | Family Medicine | 700 High St Fl 9, Williamsport, PA 17701-3100 | 2005-07-08 |
| Street Address |
459 JACK MARTIN BLVD |
| City | BRICK |
| State | NJ |
| Zip Code | 08724-7724 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689665358 | James Aloysius Clarke | Family Medicine | 459 Jack Martin Blvd, Suite 1, Brick, NJ 08724-7724 | 2005-11-02 |
| 1407212905 | Coastal Back and Pain Institute | Anesthesiology | 459 Jack Martin Blvd, Brick, NJ 08724-7724 | 2016-01-13 |
| 1275977555 | Harshil Patel | Internal Medicine | 459 Jack Martin Blvd, Brick, NJ 08724-7724 | 2013-04-17 |
| 1740471580 | Ninfa A Alcasid | Internal Medicine | 459 Jack Martin Blvd, Brick, NJ 08724-7724 | 2007-08-07 |
| 1649496043 | Theodore B Lygas Md F A C S Pa | Surgery | 459 Jack Martin Blvd, Suite 5a, Brick, NJ 08724-7724 | 2007-04-17 |
| 1528117207 | Theodore B. Lygas | Surgery | 459 Jack Martin Blvd, Suite 5a, Brick, NJ 08724 | 2007-01-10 |
| 1073619318 | Andrew L. Simon M.d., F.a.c.s, P.a. | Urology | 459 Jack Martin Blvd, Suite 3, Brick, NJ 08724-7724 | 2006-09-15 |
| 1508807082 | Virendra Patel | Internal Medicine | 459 Jack Martin Blvd, Brick, NJ 08724-7724 | 2006-06-08 |
| 1992767388 | Andrew L. Simon | Urology | 459 Jack Martin Blvd, Suite 3, Brick, NJ 08724-7724 | 2006-04-03 |
| 1528048055 | Hojun Yoo | Internal Medicine | 459 Jack Martin Blvd, Ste 4, Brick, NJ 08724-7724 | 2006-01-19 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790386498 | Mark Malak | Pharmacist | 668 New Jersey Ave # 70, Brick, NJ 08724 | 2020-11-08 |
| 1699381681 | Kimberly Granai | Nurse Practitioner | 1617 Nj-88, Brick Township, NJ 08724 | 2020-09-16 |
| 1407461346 | Marina N Samuel | Pharmacist | 1890 Rt 88, Brick, NJ 08724 | 2020-09-08 |
| 1255974440 | Diana Rachel Williamson | Pharmacy Technician | 1610 Rt. 88 West, Suite 103, Brick, NJ 08724 | 2019-10-21 |
| 1710536842 | Stephanie Ann Papa | Nurse Practitioner | 2125 Nj 88, Brick, NJ 08724 | 2019-09-11 |
| 1417504515 | Susan B Anthony | Physical Therapist | 676 Overlook Ct, Brick, NJ 08724 | 2019-08-22 |
| 1831688076 | Jennifer S Cashin | Social Worker | 1500 Nj-88, Brick, NJ 08724 | 2018-05-03 |
| 1528555315 | James Kish Pt | Physical Therapist | 602 Yellowbrick Rd, Brick, NJ 08724 | 2018-04-17 |
| 1396262200 | Michael Stephen Zito-govert | Nurse Practitioner | 1640 Route 88 West, Suite 203, Brick, NJ 08724 | 2017-08-23 |
| 1083140420 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1200 Route 70 East, Brick, NJ 08724 | 2017-05-04 |
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| Taxonomy Code | 2086X0206X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Surgical Oncology |
| A surgical oncologist is a well-qualified surgeon who has obtained additional training and experience in the multidisciplinary approach to the prevention, diagnosis, treatment, and rehabilitation of cancer patients, and devotes a major portion of his or her professional practice to these activities and cancer research. |
| Notes: Source: Society of Surgical Oncology, 2007 [1/1/2008: definition added, source added, 7/1/2009: definiition reformatted] Additional Resources: http://www.surgonc.org/ ; American Board of Medical Specialties, 2007, www.abms.org ; American Board of Surgery, 2007, http://www.absurgery.org/ Surgical oncology is a recognized fellowship subspecialty program of surgery. Separate board certification is not currently offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205034816 | Ocean Surgical & Oncology Associates, P.c | Surgery | 478 Brick Blvd, Brick, NJ 08723-6077 | 2007-07-05 |
| 1194920637 | Tarun Bhandari | Surgery | 478 Brick Blvd, Brick, NJ 08723-6077 | 2007-06-15 |
| 1649496043 | Theodore B Lygas Md F A C S Pa | Surgery | 459 Jack Martin Blvd, Suite 5a, Brick, NJ 08724-7724 | 2007-04-17 |
| 1528117207 | Theodore B. Lygas | Surgery | 459 Jack Martin Blvd, Suite 5a, Brick, NJ 08724 | 2007-01-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124336623 | Sang M Lee, Md Pa | Surgery | 65 Mountain Blvd Ext., Suite 206, Warren, NJ 07059-2633 | 2010-09-17 |
| 1902125701 | Atuhani Seth Burnett | Surgery | 150 Bergen Street, Suite E-401, Newark, NJ 07101 | 2010-05-19 |
| 1376785360 | Vadim P Koshenkov | Surgery | 195 Little Albany St Ste 3001, New Brunswick, NJ 08901-1914 | 2009-04-06 |
| 1699927566 | Thomas Lee Jang | Surgery | 195 Little Albany Street, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ 08903 | 2008-10-22 |
| 1265690549 | Richard Stockton Weeder | Surgery | 45 Green Ave, Lawrenceville, NJ 08648-1623 | 2008-05-23 |
| 1275708067 | John Alkhas | Surgery | 38 Sawgrass St, Jackson, NJ 08527-4023 | 2008-04-23 |
| 1700086360 | Ames Lawrence Filippone Jr. | Surgery | 22 Hilltop Cir, Morristown, NJ 07960-6328 | 2007-07-23 |
| 1396758983 | Sang M Lee | Surgery | 65 Mountain Blvd. Ext., Suite 206, Warren, NJ 07059-2633 | 2006-08-14 |
| 1962421339 | Martin S Karpeh | Surgery | 20 Prospect Ave Suite 406, Hackensack Umc, Hackensack, NJ 07601 | 2006-07-18 |
| 1083665053 | Thangamani Seenivasan | Surgery | 30 Rehill Avenue, Suite 3400, Somerville, NJ 08876-2500 | 2006-05-15 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.