Individual provider Active NPI

Jose Nieves, D.O.

  • Critical Care Medicine (Internal Medicine) Physician
  • Cherry Hill, NJ
National Provider Identifier
1588045348
Registry record updated May 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
25MB10497900 Issued in NJ
Practice address
2201 Chapel Ave W
Cherry Hill, NJ 08002-2048
Phone
(856) 513-4124
NPI assigned
Jun 17, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MB10497900 NJ
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 25MB10497900 NJ Primary

Addresses

Primary practice location

2201 Chapel Ave W
Cherry Hill, NJ 08002-2048

Mailing address

333 Laurel Oak Rd Ste B
Voorhees, NJ 08043-4453
Phone (856) 513-4124

Other practice location 1

42 E Laurel Rd
Suite 3100
Stratford, NJ 08084-1354
Phone (856) 566-2753

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
I20200520001584 NJ Practitioner - Internal Medicine 0446681761 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Philadelphia College of Osteopathic Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kennedy Medical Group Practice, P.C.Group PAC ID 2860616877, 417 clinicians

Practice addresses (Care Compare)

435 Hurffville Cross Keys Rd
Turnersville, NJ 08012-2453
Phone (856) 513-4124

Hospital & facility affiliations

  • Jefferson Stratford Hospital Hospital, Stratford, NJ, CCN 310086
  • Thomas Jefferson University Hospital Hospital, Philadelphia, PA, CCN 390174

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MB10497900NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kennedy Medical Group Practice P.C. Internal Medicine CurrentSince Jul 1, 2020 Accepting new patients
Kennedy Medical Group Practice PC CurrentSince Jul 1, 2020 Accepting new patients
Kennedy Medical Group Practice, P.C. Internal Medicine CurrentSince Jun 15, 2021 Accepting new patients
Kennedy University Hospital Inc. Past Accepting new patients

Locations

2201 Chapel Ave W
Cherry Hill, NJ 08002
Phone (856) 488-6500

457 Haddonfield Rd
Ste 110
Cherry Hill, NJ 08002
Phone (856) 406-4091

151 Fries Mill Rd
Ste 301
Turnersville, NJ 08012
Phone (856) 374-1881

333 Laurel Oak Rd
Ste B
Voorhees, NJ 08043
Phone (856) 513-4124

Organizations & group practices 4

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": "1434499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715731200000",
    "number": "1588045348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 LAUREL OAK RD STE B",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080434453",
            "telephone_number": "856-513-4124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 CHAPEL AVE W",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080022048",
            "telephone_number": "856-513-4124"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "42 E Laurel Rd",
            "address_2": "Suite 3100",
            "address_purpose": "LOCATION",
            "city": "Stratford",
            "state": "NJ",
            "postal_code": "080841354",
            "country_code": "US",
            "telephone_number": "856-566-2753",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIEVES",
        "first_name": "JOSE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-17",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MB10497900",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "NJ",
            "license": "25MB10497900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cherry Hill, NJ

Sources for this page

Verify at the official NPI Registry.