Individual provider Active NPI

Reynold A Panettieri Jr., MD

  • Pulmonary Disease Physician
  • New Brunswick, NJ
National Provider Identifier
1104830629
Registry record updated Apr 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
25MA09773100 Issued in NJ
Practice address
125 Paterson St Ste 5100
New Brunswick, NJ 08901-1962
Phone
(732) 235-7840
Fax
(732) 235-6524
NPI assigned
Jul 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MA09773100 NJ
Pulmonary Disease Physician 207RP1001X MD032459E PA
Pulmonary Disease Physician 207RP1001X 25MA09773100 NJ Primary

Addresses

Primary practice location

125 Paterson St Ste 5100
New Brunswick, NJ 08901-1962

Mailing address

66 W Gilbert St FL 2
Tinton Falls, NJ 07701-4947
Phone (201) 759-6921

Other practice location 1

1 Robert Wood Johnson Pl
New Brunswick, NJ 08901-1928
Phone (732) 828-3000

Other identifiers 1

IdentifierTypeStateIssuer
0011230140001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20101108000046 PA Practitioner - Critical Care (Intensivists) 3173718921 Reassigns benefits to 1 organization
I20151207002946 NJ Practitioner - Pulmonary DiseasePractitioner - Internal Medicine 3173718921 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Internal Medicine
Education
Perelman School of Med at the University of Pennsylvania, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

125 Paterson St
New Brunswick, NJ 08901-1962
Phone (732) 235-7840

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.4 of 100Reported as group
Quality
70.64
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn - Medical Group Internal Medicine CurrentSince Oct 18, 1988 Accepting new patients
University of Penn - Medical Group Internal Medicine Current Accepting new patients
Rutgers Health-RWJ Scleroderma Program Current Accepting new patients
Rutgers Health-RWJ Primary Medicine Group Internal Medicine Current Accepting new patients
Rutgers Health-RWJ Scleroderma Program Pulmonary Disease CurrentSince Nov 15, 2015 Accepting new patients
University of Penn-Medical Group CurrentSince Oct 18, 1988 Accepting new patients
Rutgers Health-RWJ Scleroderma Program CurrentSince Feb 1, 2021 Accepting new patients
Rutgers Health-RWJ Scleroderma Program Current Accepting new patients
Rutgers Health-RWJ Scleroderma Program Current Accepting new patients
Rutgers Health-RWJ Scleroderma Program Current Accepting new patients
Rutgers Health-RWJ Scleroderma Program CurrentSince Feb 1, 2021 Accepting new patients
Rutgers Health-RWJ Scleroderma Program Past Accepting new patients

Locations

1 Rwj Pl
New Brunswick, NJ 08901
Phone (732) 235-7887

125 Paterson St
Ste 5100
New Brunswick, NJ 08901
Phone (732) 235-7060

125 Paterson St
Ste 6100
New Brunswick, NJ 08901
Phone (732) 235-6561

125 Paterson St
Ste 5200B
New Brunswick, NJ 08901
Phone (732) 235-6511

125 Paterson St
New Brunswick, NJ 08901
Phone (732) 235-6511

66 W Gilbert St
Fl 2
Tinton Falls, NJ 07701
Phone (732) 212-0051

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

Interoperability endpoints

  • Direct secure messaging: rpanettieri18202@epicdirect.rwjbh.org

Organizations & group practices 12

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.

Hospital & facility affiliations 1

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": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712707200000",
    "number": "1104830629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 W GILBERT ST FL 2",
            "city": "TINTON FALLS",
            "state": "NJ",
            "postal_code": "077014947",
            "telephone_number": "201-759-6921",
            "fax_number": "732-212-0713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 PATERSON ST STE 5100",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089011962",
            "telephone_number": "732-235-7840",
            "fax_number": "732-235-6524"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Robert Wood Johnson Pl",
            "address_purpose": "LOCATION",
            "city": "New Brunswick",
            "state": "NJ",
            "postal_code": "089011928",
            "country_code": "US",
            "telephone_number": "732-828-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PANETTIERI",
        "first_name": "REYNOLD",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2024-04-10",
        "certification_date": "2024-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA09773100",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "PA",
            "license": "MD032459E",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NJ",
            "license": "25MA09773100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0011230140001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Brunswick, NJ

Sources for this page

Verify at the official NPI Registry.