Individual provider Active NPI

Philip G Woodham

  • Internal Medicine Physician
  • Hackensack, NJ
National Provider Identifier
1174667836
Registry record updated Aug 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MA67550 Issued in NJ
Practice address
20 Prospect Ave
Suite 715
Hackensack, NJ 07601-1997
Phone
(201) 881-0721
Fax
(201) 881-0725
NPI assigned
Feb 16, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2015

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 MA67550 NJ Primary

Addresses

Primary practice location

20 Prospect Ave
Suite 715
Hackensack, NJ 07601-1997

Mailing address

452 Old Hook Rd
2ND Floor
Emerson, NJ 07630-1381
Phone (201) 666-3900

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
I20101026001327 NJ Practitioner - Internal Medicine 7012100704 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Temple University School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hackensack Meridian Health Medical Group - Primary Care PCGroup PAC ID 7911003330, 364 clinicians

Practice addresses (Care Compare)

20 Prospect Ave
Hackensack, NJ 07601-1989
Phone (551) 996-5585

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.09 of 100Reported as apm
Quality
86.89
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA67550NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hackensack Meridian Health Medical Group - Primary Care PC Internal Medicine CurrentSince Jan 1, 2023 Accepting new patients
Meridian Medical Group - Specialty Care, PC Internal Medicine Past Accepting new patients
HMH Hospitals Corporation Past Accepting new patients

Locations

985 Cedar Bridge Ave
Brick, NJ 08723
Phone (732) 477-5600

452 Old Hook Rd
Fl 2
Emerson, NJ 07630
Phone (201) 599-1336

20 Prospect Ave
Ste 715
Hackensack, NJ 07601
Phone (201) 342-6600

20 Prospect Ave
Hackensack, NJ 07601
Phone (201) 996-2816

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

300 Perrine Rd
Ste 324
Old Bridge, NJ 08857
Phone (732) 753-9890

Interoperability endpoints

  • FHIR API: https://mepic.hmhn.org/fhir/api/FHIR/R4/
  • Direct secure messaging: philip.woodham@direct.hackensackmeridian.org

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 and National Provider Directory roles.

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": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440374400000",
    "number": "1174667836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "452 OLD HOOK RD",
            "address_2": "2ND FLOOR",
            "city": "EMERSON",
            "state": "NJ",
            "postal_code": "076301381",
            "telephone_number": "201-666-3900",
            "fax_number": "201-261-0505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 PROSPECT AVE",
            "address_2": "SUITE 715",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011997",
            "telephone_number": "201-881-0721",
            "fax_number": "201-881-0725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODHAM",
        "first_name": "PHILIP",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-16",
        "last_updated": "2015-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "MA67550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackensack, NJ

Sources for this page

Verify at the official NPI Registry.