Colin A, Pemberton, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

025MA08530400 Issued in NJ

Practice address

500 Orange St
Suite 1
Newark, NJ 07107-2944

Phone

(973) 842-8398

NPI assigned

Feb 20, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: cpemberton@direct.rwjbh.org

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.

• Cardiology and Vascular Consultants of New Jersey

  • Cardiovascular Disease Physician
  • Maplewood, NJ
  • NPI 1629391180
  NPD (past)

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

{
    "created_epoch": "1235088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426636800000",
    "number": "1891935557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 DEVONSHIRE TER",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070522708",
            "telephone_number": "973-444-0983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 ORANGE ST",
            "address_2": "SUITE 1",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071072944",
            "telephone_number": "973-842-8398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEMBERTON",
        "first_name": "COLIN",
        "middle_name": "A,",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-02-20",
        "last_updated": "2015-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "025MA08530400",
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NJ",
            "license": "025MA08530400",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0198323",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie Peguero, RN
• Mingzhuo Pei
• Daniel Peikes, DMD
• Pemberton M.D P.C
• Clyde A. Pemberton, M.D.
• Velma Opal Pemberton, APN
• Edwin Antonio Pena, MD
• Evelyn Pena, RD
• Rafael A Pena Jr., LCADC
• Valerie Peng

• Internal Medicine Physician in Newark, NJ
• Providers in Newark, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.