Individual provider Active NPI

Jean Kamala Mallipudi, MD

  • Internal Medicine Physician
  • Newton, NJ
National Provider Identifier
1053052050
Registry record updated Jan 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA12886100 Issued in NJ
Practice address
175 High St
Newton, NJ 07860-1004
Phone
(973) 579-8321
Fax
(973) 383-4572
NPI assigned
Apr 5, 2022
Last updated
Jan 16, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MA12886100 NJ Primary

Addresses

Primary practice location

175 High St
Newton, NJ 07860-1004

Mailing address

PO Box 416457
Boston, MA 02241-6457
Phone (844) 362-1735

Other practice location 1

651 Willow Grove St
Hackettstown, NJ 07840-1799
Phone (908) 441-1161

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251217004855 NJ Practitioner - HospitalistPractitioner - Internal Medicine 7214422286 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Practice Associates Medical GroupGroup PAC ID 5890703177, 1,412 clinicians

Practice addresses (Care Compare)

175 High St
Newton, NJ 07860-1004
Phone (973) 383-2121

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA12886100NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Practice Associates Medical Group Internal Medicine CurrentSince Nov 1, 2025 Accepting new patients
Ahs Hospital Corp Past Accepting new patients

Locations

651 Willow Grove St
Hackettstown, NJ 07840
Phone (908) 441-1161

100 Madison Ave
Morristown, NJ 07960
Phone (973) 538-5210

175 High St
Newton, NJ 07860
Phone (973) 383-2121

99 Beauvoir Ave
Summit, NJ 07901
Phone (908) 522-2232

Organizations & group practices 2

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

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1649116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768521600000",
    "number": "1053052050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 416457",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022416457",
            "telephone_number": "844-362-1735",
            "fax_number": "973-290-7495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 HIGH ST",
            "city": "NEWTON",
            "state": "NJ",
            "postal_code": "078601004",
            "telephone_number": "973-579-8321",
            "fax_number": "973-383-4572"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "651 Willow Grove St",
            "address_purpose": "LOCATION",
            "city": "Hackettstown",
            "state": "NJ",
            "postal_code": "078401799",
            "country_code": "US",
            "telephone_number": "908-441-1161",
            "fax_number": "908-441-1152",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALLIPUDI",
        "first_name": "JEAN",
        "middle_name": "KAMALA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-05",
        "last_updated": "2026-01-16",
        "certification_date": "2026-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA12886100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newton, NJ

Sources for this page

Verify at the official NPI Registry.