Individual provider Active NPI

Jose Polanco

  • Gerontology Nurse Practitioner
  • Union, NJ
National Provider Identifier
1043854961
Registry record updated Jul 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
26NJ01012600 Issued in NJ
Practice address
8 Jensen LN
Union, NJ 07083-7925
Phone
(973) 725-4078
NPI assigned
Nov 4, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LG0600X 26NJ01012600 NJ Primary

Addresses

Primary practice location

8 Jensen LN
Union, NJ 07083-7925

Mailing address

8 Jensen LN
Union, NJ 07083-7925

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201027000684 NJ Practitioner - Nurse Practitioner 2860812146 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NJ01012600NJMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Hope Hospice, Inc Multi-Specialty CurrentSince Sep 1, 2020 Accepting new patients
Medical Clinic Caring International & Wellness Center LLC Multi-Specialty CurrentSince Nov 10, 2019 Accepting new patients
Medical Clinic Caring International & Wellness Center LLC Multi-Specialty CurrentSince Nov 1, 2023 Accepting new patients
Center for Hope Hospice, Inc Multi-Specialty CurrentSince Sep 1, 2020 Accepting new patients
Union County Health Care Associates LLC Multi-Specialty CurrentSince Sep 22, 2020 Accepting new patients
MD Care Urgent Center LLC Multi-Specialty PastSince Dec 1, 2010 Accepting new patients

Locations

637 Westfield Ave
Elizabeth, NJ 07208
Phone (908) 691-3800

300 South Ave
Garwood, NJ 07027
Phone (908) 232-2273

2005 Saint Georges Ave
Rahway, NJ 07065
Phone (732) 381-3740

1900 Raritan Rd
Scotch Plains, NJ 07076
Phone (908) 288-9138

33 Overlook Rd
Ste 304
Summit, NJ 07901
Phone (732) 381-3740

2333 Morris Ave
Union, NJ 07083
Phone (908) 353-1111

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1572825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784592000000",
    "number": "1043854961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 JENSEN LN",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070837925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 JENSEN LN",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070837925",
            "telephone_number": "973-725-4078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLANCO",
        "first_name": "JOSE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-11-04",
        "last_updated": "2026-07-21",
        "certification_date": "2026-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NJ",
            "license": "26NJ01012600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Union, NJ

Sources for this page

Verify at the official NPI Registry.