NPIMap

Individual provider Active NPI

Peter G. Polos, MD

  • Pulmonary Disease Physician
  • Edison, NJ
National Provider Identifier
1285634501
Registry record updated Jul 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
25MA07459300 Issued in NJ
Practice address
65 James St
Edison, NJ 08820-3947
Phone
(732) 321-7010
Fax
(732) 744-5873
NPI assigned
Jul 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MA07459300 NJ
Pulmonary Disease Physician 207RP1001X 25MA07459300 NJ Primary

Addresses

Primary practice location

65 James St
Edison, NJ 08820-3947

Mailing address

65 James St
Edison, NJ 08820-3947
Phone (732) 321-7010

Other identifiers 1

IdentifierTypeStateIssuer
0041599MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040729000328 NJ Practitioner - Pulmonary DiseasePractitioner - Internal Medicine 2466422290 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Internal Medicine
Education
Louisiana State University School of Medicine in New Orleans, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

65 James St
Edison, NJ 08820-3947
Phone (732) 321-7189

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
HMH Hospitals Corporation CurrentSince Apr 1, 2022 Accepting new patients
Summit Medical Group PA CurrentSince May 1, 2004 Accepting new patients
Community Hospital Group, Inc. CurrentSince Oct 21, 2021 Accepting new patients
HMH Hospitals Corporation CurrentSince Apr 1, 2022 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Jan 1, 2023 Accepting new patients
Summit Medical Group PA CurrentSince May 1, 2004 Accepting new patients
Community Hospital Group Inc Current Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC Internal Medicine CurrentSince Jan 1, 2023 Accepting new patients
Community Hospital Group, Inc Past Accepting new patients
Community Hospital Group, Inc Past Accepting new patients
Hackensack Meridian Health Medical Group - Complex Care PC Internal Medicine Past Accepting new patients
Hospitalists Emo, LLC Past Accepting new patients

Locations

1 Diamond Hill Rd
Berkeley Heights, NJ 07922
Phone (908) 277-8868

65 James St
Edison, NJ 08820
Phone (732) 321-7010

65 James St
Lot G
Edison, NJ 08820
Phone (732) 321-7487

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

120 Summit Ave
Summit, NJ 07901
Phone (908) 790-6535

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD
  • Direct secure messaging: peter.polos@direct.hackensackmeridian.org

Organizations & group practices 12

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 2

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": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248134400000",
    "number": "1285634501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 JAMES ST",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088203947",
            "telephone_number": "732-321-7010",
            "fax_number": "732-744-5873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 JAMES ST",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088203947",
            "telephone_number": "732-321-7010",
            "fax_number": "732-744-5873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLOS",
        "first_name": "PETER",
        "middle_name": "G.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-28",
        "last_updated": "2009-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA07459300",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NJ",
            "license": "25MA07459300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0041599",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edison, NJ

Sources for this page

Verify at the official NPI Registry.