Individual provider Active NPI

Bruce Pomeranz, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Saddle Brook, NJ
National Provider Identifier
1710975859
Registry record updated Oct 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
25MA05980300 Issued in NJ
Practice address
300 Market St
Saddle Brook, NJ 07663-5309
Phone
(201) 368-6047
NPI assigned
Oct 12, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 25MA05980300 NJ Primary
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X 25MA05980300 NJ
Electrodiagnostic Medicine Physician 204R00000X 25MA05980300 NJ

Addresses

Primary practice location

300 Market St
Saddle Brook, NJ 07663-5309

Mailing address

4716 Old Gettysburg Rd
Legal Department
Mechanicsburg, PA 17055-4325
Phone (717) 972-1139

Other identifiers 1

IdentifierTypeStateIssuer
0004375MedicaidNJ

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
I20040729001282 NJ Practitioner - Physical Medicine and RehabilitationPractitioner - Pain Management 2860462405 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and RehabilitationAlso: Pain Management
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kessler Professional Services LLCGroup PAC ID 2860462652, 42 clinicians

Practice addresses (Care Compare)

1199 Pleasant Valley Way
West Orange, NJ 07052-1424
Phone (973) 731-3600

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA05980300NJMDElectrodiagnostic Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kessler Professional Services LLC CurrentSince Jul 1, 2004 Accepting new patients

Locations

240 Central Ave
East Orange, NJ 07018
Phone (973) 414-3473

300 Market St
Saddle Brook, NJ 07663
Phone (201) 368-6000

1199 Pleasant Valley Way
West Orange, NJ 07052
Phone (973) 414-4755

4714 Gettysburg Rd
Mechanicsburg, PA 17055
Phone (888) 735-6332

Interoperability endpoints

  • Direct secure messaging: brucepomeranz@kps.allscriptsdirect.net

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1129075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350432000000",
    "number": "1710975859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4716 OLD GETTYSBURG RD",
            "address_2": "LEGAL DEPARTMENT",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170554325",
            "telephone_number": "717-972-1139",
            "fax_number": "717-975-9981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 MARKET ST",
            "city": "SADDLE BROOK",
            "state": "NJ",
            "postal_code": "076635309",
            "telephone_number": "201-368-6047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POMERANZ",
        "first_name": "BRUCE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-12",
        "last_updated": "2012-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NJ",
            "license": "25MA05980300",
            "primary": true
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "NJ",
            "license": "25MA05980300",
            "primary": false
        },
        {
            "code": "204R00000X",
            "taxonomy_group": "",
            "desc": "Electrodiagnostic Medicine",
            "state": "NJ",
            "license": "25MA05980300",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0004375",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saddle Brook, NJ

Sources for this page

Verify at the official NPI Registry.