NPIMap

Individual provider Active NPI

Enas Khanneh

  • Hospitalist Physician
  • Berkeley Heights, NJ
National Provider Identifier
1487078655
Registry record updated Aug 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
25MA09947000 Issued in NJ
Practice address
1 Diamond Hill Rd
Berkeley Heights, NJ 07922-2104
Phone
(866) 396-9344
Fax
(908) 830-0920
NPI assigned
Feb 9, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 49697 AZ
Student in an Organized Health Care Education/Training Program 390200000X
Hospitalist Physician 208M00000X 25MA09947000 NJ Primary

Addresses

Primary practice location

1 Diamond Hill Rd
Berkeley Heights, NJ 07922-2104

Mailing address

1 Diamond Hill Rd
Berkeley Heights, NJ 07922-2104
Phone (908) 273-4300

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
I20170829000151 NJ Practitioner - Internal Medicine 6406178474 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Practice Associates Medical GroupGroup PAC ID 5890703177, 1,412 clinicians

Practice addresses (Care Compare)

99 Beauvoir Ave
Summit, NJ 07902-3533
Phone (908) 522-2000

Hospital & facility affiliations

  • Atlantic Visiting Nurse Hospice, Morristown, NJ, CCN 311503
  • Overlook Medical Center Hospital, Summit, NJ, CCN 310051
  • Morristown Medical Center Hospital, Morristown, NJ, CCN 310015
  • Memorial Hospital for Cancer and Allied Diseases Hospital, New York, NY, CCN 330154

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA09947000NJMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Passaic Hospitalist Services, LLC Hospitalist CurrentSince Apr 16, 2024 Accepting new patients
Internal Medicine and Geriatrics Practice, Inc CurrentSince Jul 1, 2017 Accepting new patients
Practice Associates Medical Group Family Medicine CurrentSince May 5, 2025 Accepting new patients
Medical Associates of Englewood, PC Internal Medicine Past Accepting new patients
Ahs Hospital Corp. Past Accepting new patients
Pioneer Medical Group PLLC Internal Medicine Past Accepting new patients

Locations

1414 Main Ave
Clifton, NJ 07011
Phone (973) 253-6000

100 Madison Ave
Morristown, NJ 07960
Phone (973) 538-5210

465 South St
Ste 103
Morristown, NJ 07960
Phone (973) 971-7130

703 Main St
Paterson, NJ 07503
Phone (973) 754-2240

99 Beauvoir Ave
Summit, NJ 07901
Phone (908) 522-2232

Organizations & group practices 7

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 8

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": "1391904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722988800000",
    "number": "1487078655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 DIAMOND HILL RD",
            "city": "BERKELEY HEIGHTS",
            "state": "NJ",
            "postal_code": "079222104",
            "telephone_number": "908-273-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 DIAMOND HILL RD",
            "city": "BERKELEY HEIGHTS",
            "state": "NJ",
            "postal_code": "079222104",
            "telephone_number": "866-396-9344",
            "fax_number": "908-830-0920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHANNEH",
        "first_name": "ENAS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-09",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "49697",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NJ",
            "license": "25MA09947000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley Heights, NJ

Sources for this page

Verify at the official NPI Registry.