Poonam Kothari, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

25MA11124800 Issued in NJ

Practice address

55 Meadowlands Pkwy
Secaucus, NJ 07094-2977

Phone

(201) 392-3210

NPI assigned

Feb 2, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA, NJ2 enrollments

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 2

Specialty

Emergency Medicine

Education

Rutgers, Robert Woood Johnson Medical School, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Integrated Medical Group P CGroup PAC ID 1355247180, 105 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Surgical Institute of Reading Hospital, Wyomissing, PA, CCN 390316
• Reading Hospital Hospital, West Reading, PA, CCN 390044

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Integrated Medical Group P C

  • Family Medicine Physician
  • Pottsville, PA
  • NPI 1336102268

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Hudson Premier Medical PC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Secaucus, NJ
  • NPI 1548809221

  Single Specialty

  Medicare reassignment NPD
• Chestnut Hill Clinic Company, LLC

  dba Behavioral Health Chestnut Hill Ave Tower Health Medical Group

  • Internal Medicine Physician
  • Philadelphia, PA
  • NPI 1508936071

  Single Specialty

  Medicare reassignment NPD
• Chestnut Hill Clinic Company, LLC

  dba Sports Medicine Chestnut Hill Manayunk THMG

  • Sports Medicine (Family Medicine) Physician
  • Philadelphia, PA
  • NPI 1811611692
  NPD
• Integrated Medical Group, P.C.

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Reading, PA
  • NPI 1881341303
  NPD
• Integrated Medical Group

  • Internal Medicine Physician
  • Pottsville, PA
  • NPI 1366406761

  Single Specialty

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Reading Hospital

  dba Reading Hospital Cardiology Hamburg

  • Cardiovascular Disease Physician
  • West Reading, PA
  • NPI 1407570880

  Hospital

  Care Compare affiliation
• Reading Hospital

  dba Reading Hospital Transplant Center

  • General Acute Care Hospital
  • West Reading, PA
  • NPI 1467007112
  Care Compare affiliation
• Reading Hospital

  dba Reading Hospital Gynecologic Oncology

  • Gynecologic Oncology Physician
  • West Reading, PA
  • NPI 1528677192

  Hospital

  Care Compare affiliation
• Reading Hospital

  dba Reading Hospital Outpatient Behavioral Health Services

  • General Acute Care Hospital
  • West Reading, PA
  • NPI 1669530069
  Care Compare affiliation
• Reading Hospital

  dba Reading Hospital Hematology Oncology

  • Hematology & Oncology Physician
  • West Reading, PA
  • NPI 1699384016

  Hospital

  Care Compare affiliation
• Reading Hospital

  dba Reading Hospital Mobile Mammography

  • Mobile Mammography Clinic/Center
  • West Reading, PA
  • NPI 1982349650

  Hospital

  Care Compare affiliation
• Surgical Institute of Reading LLC

  dba Reading Surgery Center of the Surgical Institute of Reading, LLC

  • Special Hospital
  • Wyomissing, PA
  • NPI 1124193511
  Care Compare affiliation

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

{
    "created_epoch": "1517529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640649600000",
    "number": "1609375864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 MEADOWLANDS PKWY",
            "city": "SECAUCUS",
            "state": "NJ",
            "postal_code": "070942977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 MEADOWLANDS PKWY",
            "city": "SECAUCUS",
            "state": "NJ",
            "postal_code": "070942977",
            "telephone_number": "201-392-3210"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1700 S Lincoln Ave",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "PA",
            "postal_code": "170427529",
            "country_code": "US",
            "telephone_number": "717-272-6621",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2752 Century Blvd",
            "address_purpose": "LOCATION",
            "city": "Wyomissing",
            "state": "PA",
            "postal_code": "196103345",
            "country_code": "US",
            "telephone_number": "610-378-8800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOTHARI",
        "first_name": "POONAM",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-02",
        "last_updated": "2021-12-28",
        "certification_date": "2021-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MD470753",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "25MA11124800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lucy Kim
• Kipnis Orthopaedic Rehab of Secaucus LLC (Kipnis Rehab of Secaucus LLC)
• Kipnis Physical Therapy and Sports Medicine
• Avani Manasa Kolla Patel, MD
• Dani Korya, M.D.
• Vinit Kothekar
• Maria A Labombarda, OD
• Jonathan Lang
• Shahram Lashgari, DMD
• Annabelle Q Layugan, RN, ANP-BC

• Emergency Medicine Physician in Secaucus, NJ
• Providers in Secaucus, NJ by specialty
• Emergency Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.