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PERRY MEDICAL GROUP OF NEW JERSEY PA
NPI 1114595592
General Practice in New York, NY

Active since June 14, 2021
169 MADISON AVE STE 90030, NEW YORK, NY 10016(978) 850-3914(646) 365-0517 Get Directions Write a Review

NPPES record last updated: June 30, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jan 24, 2023, Dec 13, 2022, Jun 17, 2021 (3 updates tracked since 2021).

About Perry Medical Group Of New Jersey Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PERRY MEDICAL GROUP OF NEW JERSEY PA (NPI 1114595592) is a healthcare organization registered as a general practice in New York, New York and active in the NPI registry since June 2021. The organization lists Jennifer Harless, Director, Rcm, as its authorized official.

NPPES Registry Identity

NPI1114595592
Entity TypeOrganization
Primary Taxonomy208D00000X
Legal Business NamePERRY MEDICAL GROUP OF NEW JERSEY PA
Location Address169 MADISON AVE STE 90030New York, NY 10016-5101
Mailing Address169 Madison Ave Ste 90030New York, NY 10016-5101 · (978) 850-3914 · Fax (646) 365-0517
Phone(978) 850-3914
Fax(646) 365-0517
Organization SubpartNo
Authorized OfficialJennifer HarlessDirector, Rcm · (508) 494-8275
Enumeration DateJune 14, 2021
Last NPPES UpdateJune 30, 20263 updates tracked since enumeration
NPPES CertifiedJune 30, 2026
✔ NPI 1114595592 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
169 MADISON AVE STE 90030, New York, NY 10016
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Perry Medical Group Of New Jersey Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

8

Medicare enrollment records show 8 clinicians reassign Medicare billing to Perry Medical Group Of New Jersey PA, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (8)

Avinash Ravilla, D.O
General Practice
NPI 1376926063
150 W 22ND ST FL 8
New York, NY 10011
(470) 594-4450
✔ PECOS✔ Accepts Medicare0.7 mi
Danielle Johnson, CRNP
Nurse Practitioner
NPI 1780349472
5000 FRANKFORD AVE
Philadelphia, PA 19124
(267) 819-1500
✔ PECOS✔ Accepts Medicare77 mi
Tara Mcgrory, CRNP
Nurse Practitioner
NPI 1326540733
3400 SPRUCE STREET
Philadelphia, PA 19104
(215) 662-6698
✔ PECOS✔ Accepts Medicare84 mi
Timothy Kelliher, MD
Neurology
NPI 1043314198
152 CONANT ST STE 200
Beverly, MA 01915
(978) 922-2226
✔ PECOS✔ Accepts Medicare203 mi
Hailey Sibbett, D.O.
Hospitalist
NPI 1306226246
2500 W FABYAN PKWY
Batavia, IL 60510
(630) 879-2110
✔ PECOS✔ Accepts Medicare751 mi
Jodi Awer
Nurse Practitioner
NPI 1154880268
8200 WALNUT HILL LN
Dallas, TX 75231
(214) 345-6789
✔ PECOS✔ Accepts Medicare1,369 mi
Brett Whaley, ACNP-BC
Nurse Practitioner
NPI 1164797643
29422 PEWTER RUN LN
Katy, TX 77494
(281) 770-0150
✔ PECOS1,445 mi
Lorena Zerwig
Nurse Practitioner
NPI 1932647302
1301 PUNCHBOWL ST
Honolulu, HI 96813
(808) 691-1000
✔ PECOS✔ Accepts Medicare4,968 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Perry Medical Group Of New Jersey PA's NPI number?

The NPI number for Perry Medical Group Of New Jersey PA is 1114595592. It was assigned to this organization in the NPPES registry on June 14, 2021.

Where is Perry Medical Group Of New Jersey PA located?

Perry Medical Group Of New Jersey PA is located at 169 Madison Ave Ste 90030, New York, NY 10016. The listed phone number is (978) 850-3914.

What is Perry Medical Group Of New Jersey PA's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Is Perry Medical Group Of New Jersey PA enrolled in Medicare?

Yes. Perry Medical Group Of New Jersey PA is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Perry Medical Group Of New Jersey PA?

According to the CMS Revalidation Reassignment List (October 2026 release), 8 clinicians in 4 Medicare specialties reassign their Medicare billing to Perry Medical Group Of New Jersey PA. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (5), General Practice (1) and Hospitalist (1). Of these, 1 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Perry Medical Group Of New Jersey PA was last updated on June 30, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.