Individual provider Active NPI

Jina Nam

  • Speech-Language Pathologist
  • East Windsor, NJ
National Provider Identifier
1154281491
Registry record updated Nov 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
41YS01281400 Issued in NJ
Practice address
54 Oxford Dr
East Windsor, NJ 08520-2124
Phone
(408) 205-4305
NPI assigned
Nov 17, 2025
Last updated
Nov 17, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 034747 NY
Speech-Language Pathologist 235Z00000X SL018346 PA
Speech-Language Pathologist 235Z00000X 8049 CT
Speech-Language Pathologist 235Z00000X 41YS01281400 NJ Primary

Addresses

Primary practice location

54 Oxford Dr
East Windsor, NJ 08520-2124

Mailing address

54 Oxford Dr
East Windsor, NJ 08520-2124

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20260305002047 NJ Practitioner - Qualified Speech Language Pathologist 1052893351 Reassigns benefits to 1 organization
I20260326002192 PA Practitioner - Qualified Speech Language Pathologist 1052893351 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1740 S St
Philadelphia, PA 19146-1514
Phone (215) 671-6330

256 Bunn Dr
Suite a
Princeton, NJ 08540-2859
Phone (609) 430-9200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8049CTMDSpeech-Language Pathologist
41YS01281400NJMDSpeech-Language Pathologist
034747NYMDSpeech-Language Pathologist
SL018346PAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical Health Care Associates of New Jersey, P.C. CurrentSince Jan 24, 2026 Accepting new patients
Clinical Health Care Associates of New Jersey, PC CurrentSince Jan 24, 2026 Accepting new patients

Locations

256 Bunn Dr
Ste A
Princeton, NJ 08540
Phone (609) 430-9200

570 Egg Harbor Rd
Ste B2
Sewell, NJ 08080
Phone (856) 256-0051

1740 South St
Philadelphia, PA 19146
Phone (215) 546-2183

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1763337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763337600000",
    "number": "1154281491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 OXFORD DR",
            "city": "EAST WINDSOR",
            "state": "NJ",
            "postal_code": "085202124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54 OXFORD DR",
            "city": "EAST WINDSOR",
            "state": "NJ",
            "postal_code": "085202124",
            "telephone_number": "408-205-4305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAM",
        "first_name": "JINA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-11-17",
        "last_updated": "2025-11-17",
        "certification_date": "2025-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "034747",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PA",
            "license": "SL018346",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CT",
            "license": "8049",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NJ",
            "license": "41YS01281400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Windsor, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.