Individual provider Active NPI

Raj Panchal, D.O.

  • Physical Medicine & Rehabilitation Physician
  • Clark, NJ
National Provider Identifier
1578097317
Registry record updated Oct 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
25MB10919900 Issued in NJ
Practice address
1180 Raritan Rd
Clark, NJ 07066-1311
Phone
(732) 388-1508
Fax
(732) 388-3040
NPI assigned
Apr 19, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 25MB10919900 NJ Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1180 Raritan Rd
Clark, NJ 07066-1311

Mailing address

550 1St Ave
New York, NY 10016-6402
Phone (212) 263-5506

Other practice location 1

550 1st Ave
New York, NY 10010
Phone (212) 263-5506

Other practice location 2

905 Allwood Rd Ste 105
Clifton, NJ 07012-1946
Phone (973) 870-0777

Other practice location 3

225 May St Unit C
Edison, NJ 08837-3266
Phone (732) 661-0570

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210112001297 NJ Practitioner - Physical Medicine and RehabilitationPractitioner - Pain ManagementPractitioner - Family Practice 2567875537 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and RehabilitationAlso: Pain Management
Education
New York College of Osteo Medicine of New York Institute of Technology, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hackensack Meridian Health Medical Group - Specialty Care PCGroup PAC ID 9133032519, 1,901 clinicians

Practice addresses (Care Compare)

30 Prospect Ave
Hackensack, NJ 07601-1915

Hospital & facility affiliations

  • JFK University Medical Center Hospital, Edison, NJ, CCN 310108

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
One Oak Medical Group, LLC Physical Medicine & Rehabilitation CurrentSince Oct 8, 2020 Accepting new patients
One Oak Medical Group, LLC CurrentSince Oct 8, 2020 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Oct 2, 2025 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Oct 2, 2025 Accepting new patients
Hackensack Meridian Health Medical Group - Complex Care PC Past Accepting new patients

Locations

905 Allwood Rd
Ste 105
Clifton, NJ 07012
Phone (973) 471-3680

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

342 Hamburg Tpke
Ste 203
Wayne, NJ 07470
Phone (973) 333-4759

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/8a279096-6ad2-4c68-ac31-bf88e291604e/
  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD

Organizations & group practices 5

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": "1492560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759363200000",
    "number": "1578097317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 1ST AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166402",
            "telephone_number": "212-263-5506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1180 RARITAN RD",
            "city": "CLARK",
            "state": "NJ",
            "postal_code": "070661311",
            "telephone_number": "732-388-1508",
            "fax_number": "732-388-3040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 1st Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "10010",
            "country_code": "US",
            "telephone_number": "212-263-5506",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "905 Allwood Rd Ste 105",
            "address_purpose": "LOCATION",
            "city": "Clifton",
            "state": "NJ",
            "postal_code": "070121946",
            "country_code": "US",
            "telephone_number": "973-870-0777",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "225 May St Unit C",
            "address_purpose": "LOCATION",
            "city": "Edison",
            "state": "NJ",
            "postal_code": "088373266",
            "country_code": "US",
            "telephone_number": "732-661-0570",
            "fax_number": "732-661-0084",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PANCHAL",
        "first_name": "RAJ",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-19",
        "last_updated": "2025-10-02",
        "certification_date": "2025-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NJ",
            "license": "25MB10919900",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clark, NJ

Sources for this page

Verify at the official NPI Registry.