Active NPI
John Pennacchi
- Medical Oncology Physician
- New Brunswick, NJ
National Provider Identifier
1396820072
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Oncology Physician
- License
- 25MA052478
- Practice address
- 195 Little Albany St
New Brunswick, NJ 08901-1914 - Phone
- (732) 235-2465
- NPI assigned
- Oct 25, 2006
- 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 |
|---|---|---|---|---|
| Medical Oncology Physician | 207RX0202X | 25MA052478 | NJ | Primary |
Addresses
Primary practice location
195 Little Albany St
New Brunswick, NJ 08901-1914
Mailing address
317 George St
University Medical Group 3Rd Floor
New Brunswick, NJ 08901-2008
Phone (732) 235-8282
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5492700 | Medicaid | NJ |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA052478 | NJ | MD | Medical Oncology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1396820072",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "317 GEORGE ST",
"address_2": "UNIVERSITY MEDICAL GROUP 3RD FLOOR",
"city": "NEW BRUNSWICK",
"state": "NJ",
"postal_code": "089012008",
"telephone_number": "732-235-8282"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "195 LITTLE ALBANY ST",
"city": "NEW BRUNSWICK",
"state": "NJ",
"postal_code": "089011914",
"telephone_number": "732-235-2465"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENNACCHI",
"first_name": "JOHN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207RX0202X",
"taxonomy_group": "",
"desc": "Internal Medicine, Medical Oncology",
"state": "NJ",
"license": "25MA052478",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5492700",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in New Brunswick, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.