Individual provider Active NPI

Carl Gregory Punla, M.D.

  • Family Medicine Physician
  • Wayne, NJ
National Provider Identifier
1770894495
Registry record updated Feb 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MA09546300 Issued in NJ
Practice address
76 Willowbrook Blvd
Wayne, NJ 07470-7002
Phone
(862) 246-7938
Fax
(862) 246-7939
NPI assigned
Jun 28, 2010
Last updated
Feb 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25MA09546300 NJ Primary
Family Medicine Physician 207Q00000X MT198044 PA

Addresses

Primary practice location

76 Willowbrook Blvd
Wayne, NJ 07470-7002

Mailing address

1 Diamond Hill Rd
Berkeley Heights, NJ 07922-2104
Phone (908) 273-4300

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
I20141022001404 NJ Practitioner - Family Practice 1658511472 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Medical Group PAGroup PAC ID 5395642276, 1,204 clinicians

Practice addresses (Care Compare)

1 Diamond Hill Rd
Berkeley Heights, NJ 07922-2104
Phone (908) 273-4300

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT198044PAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group PA CurrentSince Feb 1, 2023 Accepting new patients
Excel Urgent Care of Paramus LLC CurrentSince Dec 1, 2014 Accepting new patients
The Radiology Group of New Jersey, LLC CurrentSince Nov 1, 2025 Accepting new patients
DRX Paramus, LLC CurrentSince Nov 1, 2025 Accepting new patients
Neighborhood Primary Care LLC CurrentSince Apr 1, 2021 Accepting new patients
Summit Medical Group PA CurrentSince Feb 1, 2023 Accepting new patients
Monmouth Digestive Health LLC PastSince Aug 17, 2020 Accepting new patients

Locations

1 Diamond Hill Rd
Berkeley Heights, NJ 07922
Phone (908) 277-8868

1210 Route 130 N
Ste 1438
Cinnaminson, NJ 08077
Phone (551) 313-0170

145 Wyckoff Rd
Ste 201
Eatontown, NJ 07724
Phone (732) 597-7333

57 US Highway 46
Ste 212
Hackettstown, NJ 07840

651 Willow Grove St
Hackettstown, NJ 07840
Phone (908) 441-1161

150 Floral Ave
New Providence, NJ 07974
Phone (908) 588-3890

175 High St
Newton, NJ 07860
Phone (973) 383-2121

110 E Ridgewood Ave
Paramus, NJ 07652
Phone (201) 265-9500

278 Route 10
Succasunna, NJ 07876
Phone (624) 775-2888

568 Route 10 W
Ste 2
Whippany, NJ 07981
Phone (973) 535-8355

484 Temple Hill Rd
Ste 104
New Windsor, NY 12553
Phone (732) 896-4444

Interoperability endpoints

  • Direct secure messaging: carl.punla.1@2983.direct.athenahealth.com

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1277683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675728000000",
    "number": "1770894495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 DIAMOND HILL RD",
            "city": "BERKELEY HEIGHTS",
            "state": "NJ",
            "postal_code": "079222104",
            "telephone_number": "908-273-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76 WILLOWBROOK BLVD",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074707002",
            "telephone_number": "862-246-7938",
            "fax_number": "862-246-7939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUNLA",
        "first_name": "CARL",
        "middle_name": "GREGORY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-28",
        "last_updated": "2023-02-07",
        "certification_date": "2023-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA09546300",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MT198044",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayne, NJ

Sources for this page

Verify at the official NPI Registry.