Individual provider Active NPI

Joan Kathryn Kowalec, M.D.

  • Rheumatology Physician
  • Newark, NJ
National Provider Identifier
1497703474
Registry record updated Mar 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
MA030441 Issued in NJ
Practice address
400 Osborne Ter
L-4
Newark, NJ 07112-2046
Phone
(973) 926-7472
Fax
(973) 923-8063
NPI assigned
May 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X MA030441 NJ Primary

Addresses

Primary practice location

400 Osborne Ter
L-4
Newark, NJ 07112-2046

Mailing address

148 Huron Dr
Chatham, NJ 07928-1238
Phone (973) 926-7472

Other identifiers 1

IdentifierTypeStateIssuer
1691805MedicaidNJ

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

LicenseStateTypeSpecialty
MA030441NJMDRheumatology Physician

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363564800000",
    "number": "1497703474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 HURON DR",
            "city": "CHATHAM",
            "state": "NJ",
            "postal_code": "079281238",
            "telephone_number": "973-926-7472",
            "fax_number": "973-923-8063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 OSBORNE TER",
            "address_2": "L-4",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071122046",
            "telephone_number": "973-926-7472",
            "fax_number": "973-923-8063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOWALEC",
        "first_name": "JOAN",
        "middle_name": "KATHRYN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-04",
        "last_updated": "2013-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "NJ",
            "license": "MA030441",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1691805",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.