Individual provider Active NPI

James Pang, PA-C

  • Medical Physician Assistant
  • Edison, NJ
National Provider Identifier
1790279446
Registry record updated Jun 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
25MP00474000 Issued in NJ
Practice address
65 James St
Edison, NJ 08820-3903
Phone
(347) 366-0143
NPI assigned
Jun 17, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 25MP00474000 NJ Primary

Addresses

Primary practice location

65 James St
Edison, NJ 08820-3903

Mailing address

623 Waterford Dr
Edison, NJ 08817-1902
Phone (347) 366-0143

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191015002547 NJ Practitioner - Physician Assistant 6406187921 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hudson MD GroupGroup PAC ID 6103240478, 110 clinicians

Practice addresses (Care Compare)

1150 Dickinson St
Elizabeth, NJ 07201-2210
Phone (908) 354-8900

1625 Anderson Ave
Suite 204
Fort Lee, NJ 07024-2748
Phone (201) 224-0011

520 N Wood Ave
Linden, NJ 07036-4147
Phone (908) 587-9300

635 Market St
Newark, NJ 07105-3618
Phone (973) 344-5454

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
25MP00474000NJMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
NJ Urgentcare Past Accepting new patients
David W. Lee MD PA PastSince Feb 6, 2007 Accepting new patients

Organizations & group practices 4

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": "1529193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529193600000",
    "number": "1790279446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "623 WATERFORD DR",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088171902",
            "telephone_number": "347-366-0143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 JAMES ST",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088203903",
            "telephone_number": "347-366-0143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANG",
        "first_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-17",
        "last_updated": "2018-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NJ",
            "license": "25MP00474000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edison, NJ

Sources for this page

Verify at the official NPI Registry.