NPIMap

Individual provider Active NPI

Clinton Alexander Ewing, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Edison, NJ
National Provider Identifier
1639112337
Registry record updated Nov 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
25MA07523100 Issued in NJ
Practice address
65 James St
Edison, NJ 08820-3947
Phone
(732) 321-7680
Fax
(732) 321-7008
NPI assigned
Jun 13, 2006
Last updated
Nov 23, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 25MA07523100 NJ Primary
Cytopathology Physician 207ZC0500X 25MA07523100 NJ

Addresses

Primary practice location

65 James St
Edison, NJ 08820-3947

Mailing address

65 James St
Edison, NJ 08820-3947
Phone (732) 321-7680

Other identifiers 1

IdentifierTypeStateIssuer
0003018MedicaidNJ

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
I20101102000427 NJ Practitioner - Pathology 8426110230 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Wake Forest University School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Jersey Pathology Consultants, P.a.Group PAC ID 5597827816, 6 clinicians

Practice addresses (Care Compare)

65 James St
Edison, NJ 08820-3947
Phone (732) 321-7680

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Central Jersey Pathology Consultants, PA Anatomic Pathology & Clinical Pathology CurrentSince Jul 1, 2003 Accepting new patients

Locations

65 James St
Edison, NJ 08820
Phone (732) 321-7010

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

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": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322006400000",
    "number": "1639112337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 JAMES ST",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088203947",
            "telephone_number": "732-321-7680",
            "fax_number": "732-321-7008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 JAMES ST",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088203947",
            "telephone_number": "732-321-7680",
            "fax_number": "732-321-7008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EWING",
        "first_name": "CLINTON",
        "middle_name": "ALEXANDER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2011-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NJ",
            "license": "25MA07523100",
            "primary": true
        },
        {
            "code": "207ZC0500X",
            "taxonomy_group": "",
            "desc": "Pathology, Cytopathology",
            "state": "NJ",
            "license": "25MA07523100",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0003018",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edison, NJ

Sources for this page

Verify at the official NPI Registry.