1. Home
  2. Directory
  3. New Jersey
  4. Newark
  5. Internal Medicine
  6. NPI Profile

DR. ARTHUR BADILLO MD
NPI 1770635484
Internal Medicine in Newark, NJ

Active since January 16, 2007PECOS EnrolledAccepts Medicare AssignmentCLIA 31D0867012 · Waiver
643 645 MT PROSPECT AVE 1ST FLOOR, NEWARK, NJ 07104(973) 484-5607(973) 484-6958 Get Directions Write a Review

NPPES record last updated: March 1, 2012. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Arthur Badillo Md NPPES

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

DR. ARTHUR BADILLO MD (NPI 1770635484) is an individual internal medicine provider in Newark, New Jersey, licensed in New Jersey (MA050122) and active in the NPI registry since January 2007. He is enrolled in Medicare PECOS, holds a CLIA Waiver certificate valid through August 31, 2026, and is a graduate of Other (1983).

NPPES Registry Identity

NPI1770635484
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameDR. ARTHUR BADILLOCredential: MD
Location Address643 645 MT PROSPECT AVE 1ST FLOORNewark, NJ 07104-3109
Mailing Address643 645 Mt Prospect Ave 1st FloorNewark, NJ 07104-3109 · (973) 484-1455 · Fax (973) 484-6958
Phone(973) 484-5607
Fax(973) 484-6958
Sole ProprietorNo
Medical School CMSOtherGraduated 1983
Enumeration DateJanuary 16, 2007
Last NPPES UpdateMarch 1, 2012
✔ NPI 1770635484 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in NJ · MA050122
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
643 645 MT PROSPECT AVE 1ST FLOOR, Newark, NJ 07104
Open in Google Maps ↗

Other Identifiers 3

Medicare ID-Type UnspecifiedBA 559075NJ
Medicaid0432709NJ
Medicare UPINC62993

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. Arthur Badillo Md 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 ID4981639184
PECOS Enrollment IDI20050927000659
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 31D0867012

Arthur Badillo MD · Newark, NJ
Active · expires Aug 31, 2026
CLIA Number31D0867012
Laboratory TypePhysician Office
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorArthur Badillo MD
Laboratory Phone(973) 484-5607
Laboratory LocationArthur Badillo MD643-645 Mt Prospect Avenue, Newark, NJ 07104
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 3

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 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.
162 services61 patients
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.
85 services52 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.
23 services23 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 07104 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
$144.86 typical visit price
range $63.84 – $190.92
Typical copayment $36.21 (range $15.96 – $47.73)
Most-billed visit code 99204
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.

Referred Medical Equipment & Supplies CMS DME claims 3

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
11 suppliers40 claims89 services$5.34 avg. paid by Medicare
Normal, low and high calibrator solution / chips A4256
DME-Other DME · category DE000N
1 supplier11 claims11 services$2.93 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
8 suppliers24 claims30 services$0.95 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Arthur Badillo's NPI number?

The NPI number for Arthur Badillo is 1770635484. It was assigned to this individual provider in the NPPES registry on January 16, 2007.

Where is Arthur Badillo located?

Arthur Badillo practices at 643 645 Mt Prospect Ave 1st Floor, Newark, NJ 07104. The listed phone number is (973) 484-5607.

What is Arthur Badillo's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Arthur Badillo enrolled in Medicare?

Yes. Arthur Badillo 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 Arthur Badillo hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 31D0867012) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Arthur Badillo accept?

Health plans from Ambetter Health and Ambetter Health of Delaware list Arthur Badillo 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.

When was this NPI record last updated?

The NPPES record for Arthur Badillo was last updated on March 1, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.