NPIMap

Individual provider Active NPI

Louis C. Jan, M.D.

  • Nephrology Physician
  • Englewood, NJ
National Provider Identifier
1831152966
Registry record updated Aug 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
MA067677 Issued in NJ
Practice address
300 Grand Ave Ste 101
Englewood, NJ 07631-6300
Phone
(201) 567-5787
Fax
(201) 567-7652
NPI assigned
Apr 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X MA067677 NJ Primary

Addresses

Primary practice location

300 Grand Ave Ste 101
Englewood, NJ 07631-6300

Mailing address

120 W 22ND St Ste 200
Oak Brook, IL 60523-1563
Phone (630) 575-5000

Other practice location 1

250 Old Hook Rd Ste 303B
Westwood, NJ 07675-3123
Phone (201) 567-5787

Other identifiers 1

IdentifierTypeStateIssuer
0003450MedicaidNJ

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address credentialing@nephdocs.com Direct

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
I20050617000213 NJ Practitioner - Internal MedicinePractitioner - Nephrology 4587608948 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Nephrology
Education
Jefferson Medical College of Thomas Jefferson University, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bergen Kidney Center PCGroup PAC ID 4183673478, 4 clinicians

Practice addresses (Care Compare)

230 E Ridgewood Ave
Paramus, NJ 07652-4142
Phone (201) 967-4000

300 Grand Ave
Suite 101
Englewood, NJ 07631-6300
Phone (201) 567-5787

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA067677NJMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bergen Kidney Center PC Nephrology CurrentSince Aug 1, 2003 Accepting new patients
Bergen County Improvement Authority CurrentSince Oct 30, 2024 Accepting new patients
Bergen County Improvement Authority CurrentSince Oct 30, 2024 Accepting new patients

Locations

300 Grand Ave
Ste 101
Englewood, NJ 07631
Phone (201) 408-5525

230 E Ridgewood Ave
Paramus, NJ 07652
Phone (201) 225-4700

250 Old Hook Rd
Ste 303B
Westwood, NJ 07675
Phone (201) 567-5787

Interoperability endpoints

  • Direct secure messaging: ljan42363@direct.acumenmd.com
  • Direct secure messaging: ljan189811@ahs.direct-ci.com

Organizations & group practices 3

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 11

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": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755820800000",
    "number": "1831152966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 W 22ND ST STE 200",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231563",
            "telephone_number": "630-575-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 GRAND AVE STE 101",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076316300",
            "telephone_number": "201-567-5787",
            "fax_number": "201-567-7652"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "250 Old Hook Rd Ste 303B",
            "address_purpose": "LOCATION",
            "city": "Westwood",
            "state": "NJ",
            "postal_code": "076753123",
            "country_code": "US",
            "telephone_number": "201-567-5787",
            "fax_number": "201-567-7652",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAN",
        "first_name": "LOUIS",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-10",
        "last_updated": "2025-08-22",
        "certification_date": "2025-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NJ",
            "license": "MA067677",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0003450",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "credentialing@nephdocs.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "120 W 22nd St Ste 200",
            "city": "Oak Brook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605231563",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Englewood, NJ

Sources for this page

Verify at the official NPI Registry.