Individual provider Active NPI

Jacques Amja, M.D.

  • Internal Medicine Physician
  • Dickson City, PA
National Provider Identifier
1053842310
Registry record updated Jul 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD472011 Issued in PA
Practice address
330 Main St
Dickson City, PA 18519-1691
Phone
(570) 330-5000
NPI assigned
Mar 27, 2017
Last updated
Jul 5, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 5, 2024

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 MD472011 PA Primary

Addresses

Primary practice location

330 Main St
Dickson City, PA 18519-1691

Mailing address

330 Main St
Dickson City, PA 18519-1691
Phone (570) 330-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20200923001084 PA Practitioner - Internal Medicine 7517232648 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pennsylvania HM Associates, PCGroup PAC ID 0547404337, 31 clinicians
Pennsylvania Hospitalist Group, LLCGroup PAC ID 3870035611, 56 clinicians

Practice addresses (Care Compare)

334 Main St
Dickson City, PA 18519-1668
Phone (507) 307-1767

746 Jefferson Ave
Scranton, PA 18510-1624
Phone (570) 348-7100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD472011PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic Current Accepting new patients
Pennsylvania Hospitalist Group, LLC CurrentSince Feb 1, 2026 Accepting new patients
Geisinger Clinic CurrentSince Jul 15, 2024 Accepting new patients
Pennsylvania HM Associates PC CurrentSince Jun 1, 2024 Accepting new patients
Geisinger Clinic CurrentSince Jul 15, 2024 Accepting new patients
Lehigh Valley Hospital- Pocono Past Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

206 E Brown St
East Stroudsburg, PA 18301
Phone (570) 420-4951

1 Hospital Dr
Lewisburg, PA 17837
Phone (570) 522-2000

3 Hospital Dr
Ste 206
Lewisburg, PA 17837
Phone (570) 522-9771

420 S Jackson St
Pottsville, PA 17901
Phone (570) 621-5000

1800 Mulberry St
Scranton, PA 18510
Phone (570) 703-7351

334 Main St
Scranton, PA 18519
Phone (570) 307-1767

746 Jefferson Ave
Scranton, PA 18510
Phone (570) 340-5079

575 N River St
Wilkes Barre, PA 18764
Phone (570) 552-1300

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1490572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720137600000",
    "number": "1053842310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 MAIN ST",
            "city": "DICKSON CITY",
            "state": "PA",
            "postal_code": "185191691",
            "telephone_number": "570-330-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 MAIN ST",
            "city": "DICKSON CITY",
            "state": "PA",
            "postal_code": "185191691",
            "telephone_number": "570-330-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMJA",
        "first_name": "JACQUES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-03-27",
        "last_updated": "2024-07-05",
        "certification_date": "2024-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD472011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dickson City, PA

Sources for this page

Verify at the official NPI Registry.