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ALFREDO S MASULLO MD PA
NPI 1336149301
Dermatology in Hackensack, NJ

Active since July 29, 2005
120 PROSPECT AVE, HACKENSACK, NJ 07601(201) 488-0707 Get Directions Write a Review

NPPES record last updated: December 19, 2007. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Alfredo S Masullo Md Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ALFREDO S MASULLO MD PA (NPI 1336149301) is a healthcare organization registered as a dermatology in Hackensack, New Jersey and active in the NPI registry since July 2005. The organization lists Alfredo S Masullo, President, as its authorized official.

NPPES Registry Identity

NPI1336149301
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameALFREDO S MASULLO MD PA
Location Address120 PROSPECT AVEHackensack, NJ 07601-2256
Mailing Address120 Prospect AveHackensack, NJ 07601-2256 · (201) 488-0707
Phone(201) 488-0707
Organization SubpartNo
Authorized OfficialAlfredo S MasulloPresident · (201) 488-0707
Enumeration DateJuly 29, 2005
Last NPPES UpdateDecember 19, 2007
✔ NPI 1336149301 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
License✔ Licensed in NJ · MA032378
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
120 PROSPECT AVE, Hackensack, NJ 07601
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Other Identifiers 2

Medicare ID-Type Unspecified103493
Medicare UPINC53267

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Alfredo S Masullo Md Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by December 31, 2026

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateNew JerseyEnrollment IDO20091020000648Non-DME Part B · Clinic/Group PracticeDue dateDecember 31, 2026
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Alfredo S Masullo MD PA, which bills Medicare for the services this clinician delivers.

Clinician (1)

Alfredo Masullo, MD
Dermatology
NPI 1255518205
120 PROSPECT AVE
Hackensack, NJ 07601
(201) 488-0707
✔ PECOS0.6 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Alfredo S Masullo MD PA's NPI number?

The NPI number for Alfredo S Masullo MD PA is 1336149301. It was assigned to this organization in the NPPES registry on July 29, 2005.

Where is Alfredo S Masullo MD PA located?

Alfredo S Masullo MD PA is located at 120 Prospect Ave, Hackensack, NJ 07601. The listed phone number is (201) 488-0707.

What is Alfredo S Masullo MD PA's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Is Alfredo S Masullo MD PA enrolled in Medicare?

Yes. Alfredo S Masullo MD PA is registered in the Medicare PECOS enrollment system.

When is Alfredo S Masullo MD PA's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (New Jersey, Clinic/Group Practice) is due for revalidation by December 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Alfredo S Masullo MD PA?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Dermatology) reassigns their Medicare billing to Alfredo S Masullo MD PA. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Alfredo S Masullo MD PA was last updated on December 19, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.