1. Home
  2. Directory
  3. New Jersey
  4. Rio Grande
  5. Specialist
  6. NPI Profile

DR. JACK FACCIOLO D.O.
NPI 1558330076
Specialist in Rio Grande, NJ

Active since March 16, 2006PECOS Enrolled
1 SECLUDED LN, RIO GRANDE, NJ 08242(609) 368-1952 Get Directions Write a Review

NPPES record last updated: December 1, 2009. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Jack Facciolo D.o. NPPES

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

DR. JACK FACCIOLO D.O. (NPI 1558330076) is an individual specialist in Rio Grande, New Jersey, licensed in New Jersey (MB039210) and active in the NPI registry since March 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1558330076
Entity TypeIndividualMale
Primary Taxonomy174400000X
Provider Legal NameDR. JACK FACCIOLOCredential: D.O.
Location Address1 SECLUDED LNRio Grande, NJ 08242-1546
Mailing Address1 Secluded LnRio Grande, NJ 08242-1546 · (609) 368-1952
Phone(609) 368-1952
Sole ProprietorNo
Enumeration DateMarch 16, 2006
Last NPPES UpdateDecember 1, 2009
✔ NPI 1558330076 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in NJ · MB039210
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
1 SECLUDED LN, Rio Grande, NJ 08242
Open in Google Maps ↗

Other Identifiers 8

Other1213261003NJ · Cigna Ppo Number
Medicare UPINE13951NJ
Medicaid2345005NJ
Other0090462000NJ · Indp Bcbs Provider Number
Other825040NJ · Cigna Hmo Number
Other1074056NJ · Horizon Nj Health Number
OtherCMS005NJ · Oxford Provider Number
Medicare ID-Type Unspecified200033285NJ · Railroad Medicare Number

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Jack Facciolo D.o. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Other Providers at the Same Location NPPES

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

DR. FREDERICK L COLE DO
Orthopaedic Surgery
1 SECLUDED LN
RIO GRANDE, NJ 08242
Cape May County (609) 868-0710

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 Jack Facciolo's NPI number?

The NPI number for Jack Facciolo is 1558330076. It was assigned to this individual provider in the NPPES registry on March 16, 2006.

Where is Jack Facciolo located?

Jack Facciolo practices at 1 Secluded Ln, Rio Grande, NJ 08242. The listed phone number is (609) 368-1952.

What is Jack Facciolo's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Is Jack Facciolo enrolled in Medicare?

Yes. Jack Facciolo is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jack Facciolo was last updated on December 1, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.