Individual provider Active NPI

Jenitta Kwong, M.D./M.P.H.

  • Pediatrics Physician
  • Princeton, NJ
National Provider Identifier
1184033482
Registry record updated Jan 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
25MA09583100 Issued in NJ
Practice address
301 N Harrison St
Princeton, NJ 08540-3512
Phone
(609) 924-5510
Fax
(609) 924-3577
NPI assigned
Aug 12, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD450110 PA
Pediatrics Physician 208000000X 25MA09583100 NJ Primary

Addresses

Primary practice location

301 N Harrison St
Princeton, NJ 08540-3512

Mailing address

301 N Harrison St
Princeton, NJ 08540-3512
Phone (609) 924-5510

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA09583100NJMDPediatrics Physician
MD450110PAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
PNP Pediatrics, LLC Pediatrics Past Accepting new patients

Organizations & group practices 1

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": "1407801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454198400000",
    "number": "1184033482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 N HARRISON ST",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085403512",
            "telephone_number": "609-924-5510",
            "fax_number": "609-924-3577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 N HARRISON ST",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085403512",
            "telephone_number": "609-924-5510",
            "fax_number": "609-924-3577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWONG",
        "first_name": "JENITTA",
        "credential": "M.D./M.P.H.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-12",
        "last_updated": "2016-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD450110",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA09583100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Princeton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.