Jamie Petkovic, APN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

355594 Issued in NY

Practice address

354 Hurffville Crosskeys Rd BLDG 2
Sewell, NJ 08080-3550

Phone

(856) 582-0381

Fax

(844) 542-2273

NPI assigned

Jan 13, 2021

Last updated

Oct 22, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ, NY2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Trustees of Columbia University in the City of New YorkGroup PAC ID 8527972546, 2,262 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
• FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/

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.

• Trustees of Columbia University in the City of New York

  • Surgery Physician
  • New York, NY
  • NPI 1508266347
  Medicare reassignment Care Compare group
• Sovereign Medical Group LLC

  • Urology Physician
  • Oradell, NJ
  • NPI 1710282082
  Medicare reassignment NPD
• Hicksville Family Medical Care, PLLC

  dba Nao Medical

  • Family Medicine Physician
  • Mineola, NY
  • NPI 1770813792
  Medicare reassignment NPD
• Statcare Urgent & Walk in Medical Care PLLC

  dba Nao Medical

  • Urgent Care Clinic/Center
  • Mineola, NY
  • NPI 1336426667
  Medicare reassignment NPD
• Sovereign Medical Group, LLC

  • Durable Medical Equipment & Medical Supplies
  • Glen Rock, NJ
  • NPI 1801266275
  NPD
• Trustees of Columbia University in the City of New York

  • Internal Medicine Physician
  • New York, NY
  • NPI 1699289488
  NPD

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

{
    "created_epoch": "1610496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761091200000",
    "number": "1205425204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "354 HURFFVILLE CROSSKEYS RD BLDG 2",
            "city": "SEWELL",
            "state": "NJ",
            "postal_code": "080803550",
            "telephone_number": "856-582-0381",
            "fax_number": "844-542-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "354 HURFFVILLE CROSSKEYS RD BLDG 2",
            "city": "SEWELL",
            "state": "NJ",
            "postal_code": "080803550",
            "telephone_number": "856-582-0381",
            "fax_number": "844-542-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETKOVIC",
        "first_name": "JAMIE",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-13",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "355594",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ01094100",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "969351",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elana Perlow
• Jennifer Lynne Perno, MPT
• Louis P. Perri, MD
• Persante Sleep Care, Inc.
• Gregory Blase Persichetti, D.O.
• Michelle Petrongolo, PSY.D., BCBA
• Thuyanh Ngoc Phan, N.P
• Pharmcierge
• Philadelphia Vamc
• Phillips Chiropractic Centre

• Family Nurse Practitioner in Sewell, NJ
• Providers in Sewell, NJ by specialty
• Family Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.