NPIMap

Individual provider Active NPI

Jenny Soledad Ayala, M.D.

  • Internal Medicine Physician
  • Emerson, NJ
National Provider Identifier
1770845430
Registry record updated Apr 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA10469500 Issued in NJ
Practice address
466 Old Hook Rd Ste 1
Emerson, NJ 07630-1368
Phone
(201) 967-8221
NPI assigned
Jun 8, 2012
Last updated
Apr 10, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 267259 NY
Hospitalist Physician 208M00000X 267259 NY
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 25MA10469500 NJ Primary

Addresses

Primary practice location

466 Old Hook Rd Ste 1
Emerson, NJ 07630-1368

Mailing address

466 Old Hook Rd Ste 1
Emerson, NJ 07630-1368
Phone (201) 967-8221

Other practice location 1

550 first ave
new york, NY 10016-6402
Phone (917) 617-3504

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
I20190201002235 NJ Practitioner - Internal MedicinePractitioner - Hospice/Palliative Care 4587808159 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospice/Palliative Care
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MPV New Jersey MD Services PCGroup PAC ID 5991097669, 146 clinicians

Practice addresses (Care Compare)

466 Old Hook Rd
Suite 1
Emerson, NJ 07630-1368
Phone (201) 967-8221

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.09 of 100Reported as apm
Quality
86.89
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA10469500NJMDInternal Medicine Physician
267259NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MPV New Jersey MD Services PC CurrentSince Feb 1, 2019 Accepting new patients
MPV New Jersey MD Services PC CurrentSince Feb 1, 2019 Accepting new patients

Locations

466 Old Hook Rd
Ste 1
Emerson, NJ 07630
Phone (201) 261-0821

Interoperability endpoints

  • Direct secure messaging: jayala202868@ahs.direct-ci.com
  • Direct secure messaging: jayala840899@nychhc.direct-ci.com

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 4

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": "1339113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554854400000",
    "number": "1770845430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "466 OLD HOOK RD STE 1",
            "city": "EMERSON",
            "state": "NJ",
            "postal_code": "076301368",
            "telephone_number": "201-967-8221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "466 OLD HOOK RD STE 1",
            "city": "EMERSON",
            "state": "NJ",
            "postal_code": "076301368",
            "telephone_number": "201-967-8221"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 first ave",
            "address_purpose": "LOCATION",
            "city": "new york",
            "state": "NY",
            "postal_code": "100166402",
            "country_code": "US",
            "telephone_number": "917-617-3504",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AYALA",
        "first_name": "JENNY",
        "middle_name": "SOLEDAD",
        "name_prefix": "Miss",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-08",
        "last_updated": "2019-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "267259",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NY",
            "license": "267259",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA10469500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Emerson, NJ

Sources for this page

Verify at the official NPI Registry.