Individual provider Active NPI

James Pormentilla, P.A.

  • Physician Assistant
  • Belleville, NJ
National Provider Identifier
1114159332
Registry record updated Aug 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1 Clara Maass Dr
Clara Maass Medical Center
Belleville, NJ 07109-3550
Phone
(973) 450-2000
Fax
(973) 251-1109
NPI assigned
Aug 21, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1 Clara Maass Dr
Clara Maass Medical Center
Belleville, NJ 07109-3550

Mailing address

PO Box 717
Livingston, NJ 07039-0717
Phone (800) 345-0064

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
I20091013000595 NJ Practitioner - Physician Assistant 0547306151 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Excel Urgent Care of NJ LLCGroup PAC ID 9638396849, 21 clinicians

Practice addresses (Care Compare)

2624 Hwy 516
Old Bridge, NJ 08857-2306
Phone (732) 952-5000

740 Route 1 N
Iselin, NJ 08830-2652
Phone (732) 874-5507

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Humc Opco LLC Current Accepting new patients

Locations

308 Willow Ave
Hoboken, NJ 07030
Phone (201) 418-1574

Interoperability endpoints

  • Direct secure messaging: james.pormentilla@direct.hobokenumc.md

Organizations & group practices 5

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": "1250812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1250812800000",
    "number": "1114159332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 717",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070390717",
            "telephone_number": "800-345-0064",
            "fax_number": "973-251-1109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CLARA MAASS DR",
            "address_2": "CLARA MAASS MEDICAL CENTER",
            "city": "BELLEVILLE",
            "state": "NJ",
            "postal_code": "071093550",
            "telephone_number": "973-450-2000",
            "fax_number": "973-251-1109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORMENTILLA",
        "first_name": "JAMES",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-21",
        "last_updated": "2009-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belleville, NJ

Sources for this page

Verify at the official NPI Registry.