Organization Active NPI

Ja Medical P.C.

  • Pulmonary Disease Physician
  • Huntington, NY
National Provider Identifier
1285224238
Registry record updated Jan 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
Legal business name
JA MEDICAL P.C.
Practice address
161 E Main St
Huntington, NY 11743-2967
Phone
(631) 760-8207
NPI assigned
Jan 23, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2021

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

Authorized official

Name
Dr. Jalil Anwar, MDNPI 1053405084
Title
Physician
Phone
(631) 760-8207

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Critical Care Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0200X
Pulmonary Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RP1001X Primary

Addresses

Primary practice location

161 E Main St
Huntington, NY 11743-2967

Mailing address

4 Savings CT
Greenlawn, NY 11740-2308
Phone (631) 760-8207

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210218001333 NY Part B Supplier - Clinic/Group Practice 2567877830 Receives reassigned benefits from 1 practitioner
Practice locations: Huntington, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D2219556Ja Medical PC161 East Main Suite One, Huntington, NY 11743Certificate of waiverApr 5, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1611360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611360000000",
    "number": "1285224238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 SAVINGS CT",
            "city": "GREENLAWN",
            "state": "NY",
            "postal_code": "117402308",
            "telephone_number": "631-760-8207",
            "fax_number": "631-549-1084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 E MAIN ST",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117432967",
            "telephone_number": "631-760-8207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JA MEDICAL P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-23",
        "last_updated": "2021-01-23",
        "certification_date": "2021-01-23",
        "status": "A",
        "authorized_official_last_name": "ANWAR",
        "authorized_official_first_name": "JALIL",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "631-760-8207",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2021; 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.