DR. JAMES PENN M.D.
NPI 1588094569
Internal Medicine - Gastroenterology in Edison, NJ

Q: What is James Penn's NPI number?

The NPI number for James Penn is 1588094569. It was assigned to this individual provider in the NPPES registry on November 12, 2013.

Q: What is James Penn's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Q: When was this NPI record last updated?

The NPPES record for James Penn was last updated on July 31, 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.

Active since November 12, 2013PECOS EnrolledAccepts Medicare Assignment

82.38/100

CMS Quality Rating

205 MAY ST STE 201, EDISON, NJ 08837(732) 661-9228(732) 661-9259 Get Directions Write a Review

NPPES record last updated: July 31, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jul 31, 2026, Jun 3, 2025, Nov 2, 2023 and 3 more (6 updates tracked since 2022).

On this page

About Dr. James Penn M.d. NPPES

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

DR. JAMES PENN M.D. (NPI 1588094569) is an individual gastroenterology provider in Edison, New Jersey, licensed in New Jersey (25MA09660900) and active in the NPI registry since November 2013. He is enrolled in Medicare PECOS, is affiliated with Robert Wood Johnson University Hospital, and is a graduate of Rutgers R W Johnson Medical School (cam/new Bruns/pisc) (2012).

NPPES Registry Identity

NPI1588094569

Entity TypeIndividualMale

Primary Taxonomy207RG0100X

Provider Legal NameDR. JAMES PENNCredential: M.D.

Location Address205 MAY ST STE 201Edison, NJ 08837-3267

Mailing Address205 May St Ste 201Edison, NJ 08837-3267 · (732) 661-9228 · Fax (732) 661-9259

Phone(732) 661-9228

Fax(732) 661-9259

Sole ProprietorYes

Medical School CMSRutgers R W Johnson Medical School (cam/new Bruns/pisc)Graduated 2012

Enumeration DateNovember 12, 2013

Last NPPES UpdateJuly 31, 20266 updates tracked since enumeration

NPPES CertifiedJuly 31, 2026

✔ NPI 1588094569 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians

Taxonomy Code207RG0100X

License✔ Licensed in NJ · 25MA09660900

Definition

An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.

205 MAY ST STE 201, Edison, NJ 08837

Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware, Oscar Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. James Penn M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9931414174

PECOS Enrollment IDI20150817001566

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

Medicare enrollment records show James Penn reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Princeton Healthcare Affiliated Physicians PC

14 mi

Family Medicine

401 RIDGE RD, SUITE 6
Dayton, NJ 08810

Reassigned Medicare billing, New Jersey enrollment
249 clinicians in this Medicare group

NPI 1770710576 (732) 329-4800

Hackensack Meridian Health Medical Group - Specialty Care PC

18 mi

Surgical Critical Care

331 NEWMAN SPRINGS RD STE 220
Red Bank, NJ 07701

Reassigned Medicare billing, New Jersey enrollment
2,844 clinicians in this Medicare group

NPI 1215989249 (732) 807-0800

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

Areas of Expertise CMS Part B claims 12

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

388 services178 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

299 services204 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

107 services95 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

101 services101 patients

Biopsy of large bowel using a flexible endoscope 45380

A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.

71 services71 patients

Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239

This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.

70 services67 patients

Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385

This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.

57 services56 patients

Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231

Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.

45 services32 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

21 services21 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

21 services21 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

14 services14 patients

Diagnostic exam of large bowel using a flexible endoscope 45378

This procedure, known as a colonoscopy, involves using a flexible tube with a light and camera to examine the large intestine. It helps detect any abnormalities such as polyps or inflammation. It's a standard procedure to ensure gut health.

12 services12 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Robert Wood Johnson University Hospital

Acute Care Hospitals · New Brunswick, NJ

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310038

LocationOne Robert Wood Johnson PlaceNew Brunswick, NJ 08901 · Middlesex County

Emergency services Birthing friendly

Jfk Medical Center

Acute Care Hospitals · Edison, NJ

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310108

Location65 James StreetEdison, NJ 08820 · Middlesex County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 08837 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$144.86 typical visit price

range $63.84 – $190.92

Typical copayment $36.21 (range $15.96 – $47.73)

Most-billed visit code 99204

Established Patient

$111.57 typical visit price

range $20.97 – $155.92

Typical copayment $27.89 (range $5.24 – $38.98)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

82.38/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

90.72

Promoting Interoperability

Improvement Activities

Cost

57.21

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KAYLA MARIE WITTENBERG

Physician Assistant

205 MAY ST STE 201
EDISON, NJ 08837

Middlesex County (732) 661-9225

DANIEL SEDHOM MD

Internal Medicine (Gastroenterology)

205 MAY ST STE 201
EDISON, NJ 08837

Middlesex County (732) 661-9225

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 James Penn's NPI number?

The NPI number for James Penn is 1588094569. It was assigned to this individual provider in the NPPES registry on November 12, 2013.

Where is James Penn located?

James Penn practices at 205 May St Ste 201, Edison, NJ 08837. The listed phone number is (732) 661-9228.

What is James Penn's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Is James Penn enrolled in Medicare?

Yes. James Penn is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for James Penn's services?

According to the CMS Revalidation Reassignment List (October 2026 release), James Penn reassigns Medicare benefits to 2 organizations: Princeton Healthcare Affiliated Physicians PC (Dayton, NJ) and Hackensack Meridian Health Medical Group - Specialty Care PC (Red Bank, NJ). Each 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 James Penn's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does James Penn accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Oscar Health list James Penn as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is James Penn affiliated with any hospitals?

According to CMS data, James Penn is affiliated with Robert Wood Johnson University Hospital and Jfk Medical Center.

When was this NPI record last updated?

The NPPES record for James Penn was last updated on July 31, 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.