Active NPI
Jordan Michael Greenberg, PA-C
- Physician Assistant
- Rahway, NJ
National Provider Identifier
1376993246
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 25MP00398200
- Practice address
- 865 Stone St
Rahway, NJ 07065-2742 - Phone
- (732) 680-7911
- NPI assigned
- Jun 21, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 25MP00398200 | NJ | Primary |
Addresses
Primary practice location
865 Stone St
Rahway, NJ 07065-2742
Mailing address
3 Century Dr
Parsippany, NJ 07054-4610
Phone (732) 680-7911
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: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160804001488 | NJ | Practitioner - Physician Assistant | 4183918709 | Reassigns benefits to 8 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- The Medical Group of New JerseyDoctors Office of West Caldwell LLC
Practice addresses (Care Compare)
154 State Route 10
East Hanover, NJ 07936-2107
Phone (973) 920-3090
556 Passaic Ave
West Caldwell, NJ 07006-7449
Phone (973) 808-2273
651 Willow Grove St
Hackettstown, NJ 07840-1799
Phone (908) 979-1621
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MP00398200 | NJ | MD | Physician Assistant |
Organizations & group practices 8
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.
-
- Multi-Specialty Clinic/Center
- Hackettstown, NJ
- NPI 1174010540
NJ
-
- Emergency Medicine Physician
- Mount Holly, NJ
- NPI 1831539568
NJ
-
- Emergency Medicine Physician
- Somerset, NJ
- NPI 1912510041
NJ
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1466467200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1492473600000",
"number": "1376993246",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 CENTURY DR",
"city": "PARSIPPANY",
"state": "NJ",
"postal_code": "070544610",
"telephone_number": "732-680-7911"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "865 STONE ST",
"city": "RAHWAY",
"state": "NJ",
"postal_code": "070652742",
"telephone_number": "732-680-7911"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREENBERG",
"first_name": "JORDAN",
"middle_name": "MICHAEL",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-06-21",
"last_updated": "2017-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NJ",
"license": "25MP00398200",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rahway, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2017; 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.