Individual provider Active NPI

Joel Nwosu-Nelson, MD

  • Internal Medicine Physician
  • Clifton, NJ
National Provider Identifier
1750350682
Registry record updated Oct 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MA065896 Issued in NJ
Practice address
1033 US Highway 46 205
Clifton, NJ 07013-7475
Phone
(973) 910-8400
NPI assigned
Mar 14, 2006
Last updated
Oct 6, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MA065896 NJ Primary

Addresses

Primary practice location

1033 US Highway 46 205
Clifton, NJ 07013-7475

Mailing address

1033 US Highway 46 205
Clifton, NJ 07013-7475
Phone (973) 910-8400

Other identifiers 1

IdentifierTypeStateIssuer
7713801MedicaidNJ

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
I20051201000066 NJ Practitioner - Internal Medicine 1456371822 Practice locations: Clifton, NJ

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1033 US Hwy 46
Suite 205
Clifton, NJ 07013-7475
Phone (973) 910-8400

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA065896NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Colfax Medical Associates LLC PastSince Sep 1, 2005 Accepting new patients
St Josephs University Medical Center Inc. Past Accepting new patients

Organizations & group practices 2

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 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": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444089600000",
    "number": "1750350682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1033 US HIGHWAY 46 205",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070137475",
            "telephone_number": "973-910-8400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1033 US HIGHWAY 46 205",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070137475",
            "telephone_number": "973-910-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NWOSU-NELSON",
        "first_name": "JOEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2015-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "MA065896",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7713801",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton, NJ

Sources for this page

Verify at the official NPI Registry.