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PROSPECT MEDICAL PC
NPI 1346365905
Internal Medicine in Hackensack, NJ

Active since March 20, 2007
277 PROSPECT AVE, HACKENSACK, NJ 07601(201) 968-1881(201) 968-0330 Get Directions Write a Review

NPPES record last updated: August 1, 2014. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Prospect Medical Pc NPPES

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

PROSPECT MEDICAL PC (NPI 1346365905) is a healthcare organization registered as an internal medicine in Hackensack, New Jersey and active in the NPI registry since March 2007. The organization lists Shan Sivendra, President, as its authorized official.

NPPES Registry Identity

NPI1346365905
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NamePROSPECT MEDICAL PC
Location Address277 PROSPECT AVEHackensack, NJ 07601-2570
Mailing Address277 Prospect Ave, Unit LgHackensack, NJ 07601-2512 · (201) 968-1881 · Fax (201) 968-0330
Phone(201) 968-1881
Fax(201) 968-0330
Organization SubpartNo
Authorized OfficialShan SivendraPresident · (201) 968-1881
Enumeration DateMarch 20, 2007
Last NPPES UpdateAugust 1, 2014
✔ NPI 1346365905 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in NJ · 25MA06930200
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X
277 PROSPECT AVE, Hackensack, NJ 07601
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Other Identifiers 4

Other201403274NJ · Tax Id
Medicare NSC7129790001NJ
Medicare UPINH07358NJ
Medicare ID-Type Unspecified086855NJ

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Prospect Medical Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Prospect Medical PC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Shan Sivendra, MD
Internal Medicine
NPI 1538154307
94 OLD SHORT HILLS RD
Livingston, NJ 07039
(201) 322-5000
✔ PECOS16 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 Prospect Medical PC's NPI number?

The NPI number for Prospect Medical PC is 1346365905. It was assigned to this organization in the NPPES registry on March 20, 2007.

Where is Prospect Medical PC located?

Prospect Medical PC is located at 277 Prospect Ave, Hackensack, NJ 07601. The listed phone number is (201) 968-1881.

What is Prospect Medical PC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Prospect Medical PC enrolled in Medicare?

Yes. Prospect Medical PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Prospect Medical PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Internal Medicine) reassigns their Medicare billing to Prospect Medical PC. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Prospect Medical PC was last updated on August 1, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years 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.