DR. MARIO R CAPIO M.D.
NPI 1356383863
Family Medicine in Pompton Plains, NJ

Q: What is Mario Capio's NPI number?

The NPI number for Mario Capio is 1356383863. It was assigned to this individual provider in the NPPES registry on June 11, 2006.

Q: What is Mario Capio's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Mario Capio was last updated on February 9, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.

Active since June 11, 2006PECOS EnrolledAccepts Medicare AssignmentCLIA 31D0997147 · Waiver

230 W PARKWAY, UNIT 10, POMPTON PLAINS, NJ 07444(973) 835-0800(973) 616-2766 Get Directions Write a Review

NPPES record last updated: February 9, 2016. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Dr. Mario R Capio M.d. NPPES

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

DR. MARIO R CAPIO M.D. (NPI 1356383863) is an individual family medicine provider in Pompton Plains, New Jersey, licensed in New Jersey (MA06454900) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS, holds a CLIA Waiver certificate valid through March 6, 2028, and is affiliated with Hackensack University Medical Center.

NPPES Registry Identity

NPI1356383863

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameDR. MARIO R CAPIOCredential: M.D.

Location Address230 W PARKWAY, UNIT 10Pompton Plains, NJ 07444-1060

Mailing AddressPo Box 416457Boston, MA 02241-6457

Phone(973) 835-0800

Fax(973) 616-2766

Sole ProprietorYes

Medical School CMSRutgers New Jersey Medical SchoolGraduated 1995

Enumeration DateJune 11, 2006

Last NPPES UpdateFebruary 9, 2016

✔ NPI 1356383863 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in NJ · MA06454900

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

230 W PARKWAY, Pompton Plains, NJ 07444

Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Mario R Capio M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5193792976

PECOS Enrollment IDI20040913000026

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 31D0997147

Mario R Capio, MD · Pompton Plains, NJ

Active · expires Mar 6, 2028

CLIA Number31D0997147

Laboratory TypePhysician Office

Certificate Effective DateMarch 7, 2026

Certificate Expiration DateMarch 6, 2028

Laboratory DirectorMario R. Capio

Laboratory Phone(973) 835-0800

Laboratory LocationMario R Capio, MD230 West Parkway, Unit 10, Pompton Plains, NJ 07444

CLIA data matches this NPI record on: Address Phone

This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 22

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

712 services421 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

698 services392 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

500 services324 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

447 services447 patients

Advance care planning, first 30 minutes 99497

Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.

323 services322 patients

Annual depression screening, 5 to 15 minutes G0444

An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.

191 services191 patients

Advance care planning, each additional 30 minutes 99498

Advance care planning involves discussing and documenting your future health care preferences in case you're unable to make decisions for yourself. Each additional 30 minutes allows more time to explore your wishes, values, and goals for treatment.

182 services181 patients

Influenza vaccine split virus, preservative free 90662

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

87 services87 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

79 services79 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

62 services62 patients

Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or G2212

This service refers to extended doctor visits where your healthcare provider spends additional time evaluating and managing your health beyond the primary procedure's required time. This includes each extra 15 minutes spent by the physician on the same day as the primary service.

43 services41 patients

Urinalysis, manual test 81002

A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.

38 services23 patients

New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

33 services33 patients

Transitional care management services for problem of high complexity 99496

Transitional care management services are designed to ensure a smooth transition from a hospital to home or another care setting for patients with complex health issues. These services include medication management, patient education, and coordination with healthcare providers.

31 services29 patients

Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment G0402

An Initial Preventive Physical Examination, also known as a "Welcome to Medicare" visit, is a one-time, face-to-face visit during your first 12 months of Medicare enrollment. It includes a review of your health, as well as education and counseling about preventive services and further screenings.

28 services28 patients

Assessment of emotional or behavioral problems 96127

Assessment of emotional or behavioral problems involves a thorough evaluation of your feelings, thoughts, and behaviors. It's a process where professionals study patterns over time to identify potential issues like anxiety, depression, or other mental health conditions.

20 services19 patients

Removal of impacted ear wax 69210

Impacted ear wax removal is a safe procedure to clear blockages in the ear canal caused by hardened ear wax. A healthcare professional uses specialized tools or a gentle irrigation method to loosen and remove the wax, improving hearing and alleviating discomfort.

18 services16 patients

Transitional care management services for problem of at least moderate complexity 99495

Transitional care management services focus on coordinating and managing your care after you leave the hospital. For moderate complexity problems, this involves managing your medications, arranging further treatments, and ensuring you have the necessary follow-ups.

16 services15 patients

Administration of vaccine 90471

Administering a vaccine involves injecting a small, safe piece of a virus or bacteria into your body. This triggers your immune system to recognize and fight off the disease in the future. It's a vital tool in preventing serious illnesses and maintaining public health.

15 services15 patients

Automated urinalysis test 81003

An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.

14 services13 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

13 services13 patients

Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit G0438

An annual wellness visit is a yearly appointment with your doctor to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's an opportunity to discuss your health status and goals and get a plan tailored for you.

11 services11 patients

Hospital Affiliations CMS Care Compare 4

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Hackensack University Medical Center

Acute Care Hospitals · Hackensack, NJ

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310001

Location30 Prospect AveHackensack, NJ 07601 · Bergen County

Emergency services Birthing friendly

Morristown Medical Center

Acute Care Hospitals · Morristown, NJ

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310015

Location100 Madison AveMorristown, NJ 07960 · Morris County

Emergency services Birthing friendly

Chilton Medical Center

Acute Care Hospitals · Pompton Plains, NJ

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310017

Location97 West ParkwayPompton Plains, NJ 07444 · Morris County

Emergency services Birthing friendly

St Joseph's University Medical Center Inc

Acute Care Hospitals · Paterson, NJ

2/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number310019

Location703 Main StPaterson, NJ 07503 · Passaic County

Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 07444 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$98.09 typical visit price

range $63.84 – $190.92

Typical copayment $24.52 (range $15.96 – $47.73)

Most-billed visit code 99203

Established Patient

$111.57 typical visit price

range $20.97 – $155.92

Typical copayment $27.89 (range $5.24 – $38.98)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

e-Prescribing

At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.

98%6,331 patients4/55-star benchmark: 100%

Provide Patient Access

At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…

0%1,537 patients1/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

12 suppliers28 claims62 services$6.39 avg. paid by Medicare

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553

DME-Other DME · category DE017N

3 suppliers15 claims15 services$184.80 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KYUNG MIN LEE NP-C

Nurse Practitioner (Adult Health)

230 W PARKWAY, #10
POMPTON PLAINS, NJ 07444

Morris County (973) 835-0800

DR. NICOLETTA FRANCESCA QUITADAMO DNP, FNP-BC

Nurse Practitioner (Family)

230 W PARKWAY
POMPTON PLAINS, NJ 07444

Morris County (973) 835-0800

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 Mario Capio's NPI number?

The NPI number for Mario Capio is 1356383863. It was assigned to this individual provider in the NPPES registry on June 11, 2006.

Where is Mario Capio located?

Mario Capio practices at 230 W Parkway Unit 10, Pompton Plains, NJ 07444. The listed phone number is (973) 835-0800.

What is Mario Capio's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Mario Capio enrolled in Medicare?

Yes. Mario Capio is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Does Mario Capio hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 31D0997147) is associated with this NPI, valid through March 6, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Mario Capio accept?

Health plans from Ambetter Health and Ambetter Health of Delaware list Mario Capio as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Mario Capio affiliated with any hospitals?

According to CMS data, Mario Capio is affiliated with Hackensack University Medical Center, Morristown Medical Center, Chilton Medical Center and St Joseph's University Medical Center Inc.

When was this NPI record last updated?

The NPPES record for Mario Capio was last updated on February 9, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.

About Dr. Mario R Capio M.d. NPPES

NPPES Registry Identity

Specialties & Licenses

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare Enrollment Status

CLIA Laboratory Certificates CMS CLIA

Certificate of Waiver · 31D0997147

Areas of Expertise CMS Part B claims 22

Hospital Affiliations CMS Care Compare 4

Hackensack University Medical Center

Morristown Medical Center

Chilton Medical Center

St Joseph's University Medical Center Inc

Physician Visit Costs CMS claims · ZIP area

Medicare Quality Performance CMS QPP · MIPS

Reported Quality Measures

Referred Medical Equipment & Supplies CMS DME claims 2

Other Providers at the Same Location NPPES 2

Frequently Asked Questions NPPES & CMS

What is Mario Capio's NPI number?

Where is Mario Capio located?

What is Mario Capio's specialty?

Is Mario Capio enrolled in Medicare?

Does Mario Capio hold a CLIA laboratory certificate?

What insurance does Mario Capio accept?

Is Mario Capio affiliated with any hospitals?

When was this NPI record last updated?

Certificate of Waiver 31D0997147