Individual provider Active NPI

Gregory Pakonis, MD

  • Anesthesiology Physician
  • Newark, NJ
National Provider Identifier
1922209717
Registry record updated Mar 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
25MA08283200 Issued in NJ
Practice address
111 Central Ave
Newark, NJ 07102-1909
Phone
(973) 877-5000
NPI assigned
May 30, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 25MA08283200 NJ Primary

Addresses

Primary practice location

111 Central Ave
Newark, NJ 07102-1909

Mailing address

3998 Fair Ridge Dr
Ste 300
Fairfax, VA 22033-2907
Phone (703) 295-9360

Other identifiers 1

IdentifierTypeStateIssuer
0139530MedicaidNJ

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
I20070831000543 NJ Practitioner - Anesthesiology 9234222548 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New Jersey Healthcare Specialists PCGroup PAC ID 2668385253, 570 clinicians

Practice addresses (Care Compare)

1450 Route 22
Mountainside, NJ 07092-2619
Phone (908) 233-2020

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA08283200NJMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North American Partners in Anesthesia of New Jersey LLC Anesthesiology CurrentSince May 15, 2013 Accepting new patients
New Jersey Healthcare Specialists PC Anesthesiology CurrentSince Jan 1, 2023 Accepting new patients
North American Partners in Anesthesia (Virginia), LLC Anesthesiology Past Accepting new patients

Locations

630 E Palisade Ave
Englewood Cliffs, NJ 07632
Phone (201) 503-0302

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

300 2nd Ave
Long Branch, NJ 07740
Phone (732) 222-5200

6 Chestnut Ridge Rd
Montvale, NJ 07645
Phone (201) 391-4700

1450 US Highway 22
Mountainside, NJ 07092
Phone (908) 228-5975

111 Central Ave
Newark, NJ 07102
Phone (973) 877-5060

703 Main St
Paterson, NJ 07503
Phone (973) 754-2240

246 Hamburg Tpke
Wayne, NJ 07470
Phone (973) 653-3366

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1180483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426550400000",
    "number": "1922209717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3998 FAIR RIDGE DR",
            "address_2": "STE 300",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220332907",
            "telephone_number": "703-295-9360",
            "fax_number": "703-766-9725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 CENTRAL AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071021909",
            "telephone_number": "973-877-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAKONIS",
        "first_name": "GREGORY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-30",
        "last_updated": "2015-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NJ",
            "license": "25MA08283200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0139530",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.