Individual provider Active NPI

Poonam Pamini Jani, M.D.

  • Internal Medicine Physician
  • Perth Amboy, NJ
National Provider Identifier
1174911952
Registry record updated Mar 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA10951200 Issued in NJ
Practice address
275 Hobart St
Perth Amboy, NJ 08861-3396
Phone
(732) 376-9333
Fax
(732) 293-0139
NPI assigned
Jan 2, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 21, 2025

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 25MA10951200 NJ Primary

Addresses

Primary practice location

275 Hobart St
Perth Amboy, NJ 08861-3396

Mailing address

11 Getty Ave
Paterson, NJ 07503-2621
Phone (973) 754-4200

Other identifiers 1

IdentifierTypeStateIssuer
0768871MedicaidNJ

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
I20210211000043 NJ Practitioner - Internal Medicine 9830470939 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Josephs Medical Group PCGroup PAC ID 8628470325, 217 clinicians

Practice addresses (Care Compare)

11 Getty Ave
BLDG 275
Paterson, NJ 07503-2806
Phone (973) 754-2000

Hospital & facility affiliations

  • St Joseph'S University Medical Center Inc Hospital, Paterson, NJ, CCN 310019

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
16773NVMDPharmacist
25MA10951200NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Josephs Medical Group PC Internal Medicine CurrentSince Aug 5, 2024 Accepting new patients
Central Jersey Medical Center, Inc. CurrentSince Mar 1, 2021 Accepting new patients
Central Jersey Medical Center, Inc CurrentSince Mar 1, 2021 Accepting new patients
St Josephs University Medical Center Inc. PastSince Aug 5, 2024 Accepting new patients

Locations

80 Johnson Ave
Newark, NJ 07108
Phone (973) 623-8592

11 Getty Ave BLDG 275
BLDG 275
Paterson, NJ 07503
Phone (973) 247-1666

703 Main St
#G
Paterson, NJ 07503
Phone (973) 754-6331

11 Getty Ave BLDG 275
BLDG 275
Paterson, NJ 07503
Phone (973) 247-1666

11 Getty Ave
Paterson, NJ 07503
Phone (973) 754-4200

275 Hobart St
Perth Amboy, NJ 08861
Phone (732) 376-6635

220 Hamburg Tpke
Ste 203
Wayne, NJ 07470

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 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": "1420156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742515200000",
    "number": "1174911952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 GETTY AVE",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075032621",
            "telephone_number": "973-754-4200",
            "fax_number": "973-754-4201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 HOBART ST",
            "city": "PERTH AMBOY",
            "state": "NJ",
            "postal_code": "088613396",
            "telephone_number": "732-376-9333",
            "fax_number": "732-293-0139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANI",
        "first_name": "POONAM",
        "middle_name": "PAMINI",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-02",
        "last_updated": "2025-03-21",
        "certification_date": "2025-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA10951200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0768871",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Perth Amboy, NJ

Sources for this page

Verify at the official NPI Registry.