NPIMap

Individual provider Active NPI

Samir C. Jethwa, DO

  • Vascular & Interventional Radiology Physician
  • Brick, NJ
National Provider Identifier
1871736108
Registry record updated Dec 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
25MB09398100 Issued in NJ
Practice address
425 Jack Martin Blvd
Brick, NJ 08724-7732
Phone
(732) 836-4752
NPI assigned
Apr 16, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2016

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X 2769431 NY
Vascular & Interventional Radiology Physician 2085R0204X 25MB09398100 NJ Primary
Diagnostic Radiology Physician 2085R0202X 25MB09398100 NJ
Diagnostic Radiology Physician 2085R0202X 2769431 NY

Addresses

Primary practice location

425 Jack Martin Blvd
Brick, NJ 08724-7732

Mailing address

425 Jack Martin Blvd
Brick, NJ 08724-7732
Phone (732) 836-4752

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
I20160401000062 NJ Practitioner - Diagnostic Radiology 5890929285 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Rowan University School of Osteopathic Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jersey Shore Imaging LLCGroup PAC ID 1355408212, 148 clinicians
Flemington Radiology Associates LLCGroup PAC ID 5294145819, 68 clinicians
University Radiology at Cooper LLCGroup PAC ID 4587053699, 78 clinicians
University Radiology Group LLCGroup PAC ID 6608868500, 239 clinicians
University Radiology-Atlantic, LLCGroup PAC ID 6901059864, 144 clinicians

Practice addresses (Care Compare)

2100 Corlies Ave
Neptune, NJ 07753-6102
Phone (732) 988-1234

2100 Wescott Dr
Flemington, NJ 08822-4603
Phone (732) 390-0040

2339 Route 70 W
Cherry Hill, NJ 08002-3315
Phone (732) 390-0040

3822 River Rd
Point Pleasant Boro, NJ 08742-2067
Phone (732) 892-1200

48 N Gilbert St
Tinton Falls, NJ 07701-4905
Phone (732) 530-5750

483 Cranbury Rd
East Brunswick, NJ 08816-3610
Phone 73239000402022

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.21 of 100Reported as group
Quality
95.54
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
88.88 of 100Reported as group
Quality
85.63
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
92.08 of 100Reported as group
Quality
90.68
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
89.93 of 100Reported as group
Quality
95.96
Improvement activities
40
Cost
73.85

Merit-based Incentive Payment System (MIPS)

Final score
96.51 of 100Reported as group
Quality
95.9
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
93.28 of 100Reported as group
Quality
86.64
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2769431NYMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Flemington Radiology Associates, LLC Diagnostic Radiology CurrentSince Aug 1, 2022 Accepting new patients
Jersey Shore Imaging, LLC Diagnostic Radiology CurrentSince Feb 1, 2022 Accepting new patients
Rwjuh Imaging at Plum Street, LLC Diagnostic Radiology CurrentSince Feb 1, 2022 Accepting new patients
University Radiology at Cooper, LLC Diagnostic Radiology CurrentSince Apr 1, 2023 Accepting new patients
University Radiology at Trinitas, LLC Diagnostic Radiology CurrentSince Feb 1, 2022 Accepting new patients
Hunterdon Medical Center Diagnostic Radiology CurrentSince May 1, 2023 Accepting new patients
University Radiology-Atlantic, LLC Diagnostic Radiology CurrentSince Feb 1, 2022 Accepting new patients

Locations

1 Robertson Dr
Ste 16
Bedminster, NJ 07921
Phone (908) 234-0205

33 Monroe St
Bridgewater, NJ 08807
Phone (908) 725-1291

2339 Route 70 W
Cherry Hill, NJ 08002
Phone (856) 406-4080

483 Cranbury Rd
East Brunswick, NJ 08816
Phone (732) 390-0030

579A Cranbury Rd
East Brunswick, NJ 08816
Phone (732) 390-0030

3 Progress St
Edison, NJ 08820
Phone (908) 753-0001

3900 Park Ave
Ste 107
Edison, NJ 08820
Phone (732) 546-6800

415 Morris Ave
Elizabeth, NJ 07208
Phone (908) 351-7600

500 Grand Ave
Englewood, NJ 07631
Phone (201) 541-0440

2100 Wescott Dr
Flemington, NJ 08822
Phone (908) 237-5420

121 State Route 31
Ste 1100
Flemington, NJ 08822
Phone (908) 782-4700

833 Lacey Rd
Forked River, NJ 08731
Phone (609) 242-2334

105 Raider Blvd
Hillsborough, NJ 08844
Phone (908) 359-9331

210 W Saint Georges Ave
Linden, NJ 07036
Phone (908) 486-1111

2315 Route 34
Ste C
Manasquan, NJ 08736
Phone (732) 974-0404

264 Amboy Ave
Metuchen, NJ 08840
Phone (732) 548-2322

111 Union Valley Rd
Monroe Twp, NJ 08831
Phone (609) 395-3470

400 W Route 38
Ste 2300
Moorestown, NJ 08057

10 Plum St
New Brunswick, NJ 08901
Phone (732) 235-6333

235 Franklin Ave
Nutley, NJ 07110
Phone (973) 235-9090

2128 State Route 35
Oakhurst, NJ 07755
Phone (732) 493-8444

3822 River Rd
Point Pleasant Boro, NJ 08742
Phone (732) 701-4848

75 Veronica Ave
Somerset, NJ 08873
Phone (732) 246-0060

699 Teaneck Rd
Teaneck, NJ 07666
Phone (201) 836-2500

48 N Gilbert St
Tinton Falls, NJ 07701
Phone (732) 530-5750

Interoperability endpoints

  • Direct secure messaging: samir.jethwa@direct.hackensackmeridian.org

Organizations & group practices 8

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.

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": "1239840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480550400000",
    "number": "1871736108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 JACK MARTIN BLVD",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087247732",
            "telephone_number": "732-836-4752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 JACK MARTIN BLVD",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087247732",
            "telephone_number": "732-836-4752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JETHWA",
        "first_name": "SAMIR",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-16",
        "last_updated": "2016-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NY",
            "license": "2769431",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NJ",
            "license": "25MB09398100",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NJ",
            "license": "25MB09398100",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "2769431",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brick, NJ

Sources for this page

Verify at the official NPI Registry.