Active NPI
Harold I Jawetz
- Internal Medicine Physician
- Clifton, NJ
National Provider Identifier
1972543585
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 34628
- Practice address
- 6 Brighton Rd
2ND Floor
Clifton, NJ 07012-1647 - Phone
- (973) 777-7911
- Fax
- (973) 777-5403
- NPI assigned
- Jun 8, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 34628 | NJ | Primary |
Addresses
Primary practice location
6 Brighton Rd
2ND Floor
Clifton, NJ 07012-1647
Mailing address
6 Brighton Rd
2ND Floor
Clifton, NJ 07012-1647
Phone (973) 777-7911
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0910601 | Medicaid | NJ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34628 | NJ | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Summit Medical Group, Inc | Internal Medicine | Past | Accepting new patients |
| SLM Nutrition, LLC | Past | Accepting new patients |
Organizations & group practices 2
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149724800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1562716800000",
"number": "1972543585",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6 BRIGHTON RD",
"address_2": "2ND FLOOR",
"city": "CLIFTON",
"state": "NJ",
"postal_code": "070121647",
"telephone_number": "973-777-7911",
"fax_number": "973-777-5403"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6 BRIGHTON RD",
"address_2": "2ND FLOOR",
"city": "CLIFTON",
"state": "NJ",
"postal_code": "070121647",
"telephone_number": "973-777-7911",
"fax_number": "973-777-5403"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAWETZ",
"first_name": "HAROLD",
"middle_name": "I",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-08",
"last_updated": "2019-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NJ",
"license": "34628",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0910601",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Clifton, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.