PRANEEJA MATTA (MD) – Hospitalist Physician, NPI 1104405620

PRANEEJA MATTA (MD) is a healthcare provider. based in Camden, New Jersey. specializing in INTERNAL MEDICINE. They hold the professional credentials MD. They hold a License No. 25MA12315800 (NJ). The NPI Number for PRANEEJA MATTA (MD) is 1104405620

Main info

Female
5 Years Of Experience
Accepts Medicare Assignment
Name
PRANEEJA MATTA (MD)
NPI
1104405620
Phone
(848) 288-6935
Address
1 FEDERAL ST STE 200
Enumeration Date
2 April 2021
Last Update Date
28 August 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
85645147002755
Graduation Year
2021 (5 years ago)
PAC ID
4385180082
Group Practice PAC ID
9335040419
Professional Enrollment ID
I20240718000534
Address ID
NJ080281403GL335XXNXXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience39
Completeness75
Years active:5State licenses:1Digital endpointsOther names

6,893 INTERNAL MEDICINE in NJ

Provider Addresses for PRANEEJA MATTA (MD)

  • 1 FEDERAL ST STE 200

    CAMDEN, NJ 081031088

    Phone: (848) 288-6935

    Fax: (732) 790-0107

    Type: Mailing

  • 1 COOPER PLZ

    CAMDEN, NJ 081031461

    Phone: (856) 342-3150

    Type: Location

  • 1903 SHIPLEY RD

    WILMINGTON, DE 198035201

    Phone: (302) 753-1501

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-07-18

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240718000534IInternal MedicineNJTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 08103)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9335040419View full group profile
NameSpecialtyState
H O S P I T A L I S TNJ
Internal MedicinePA
Nurse PractitionerNJ
Internal MedicineNJ
-NJ
Internal Medicine, HospitalistNJ
Internal MedicinePA
H O S P I T A L I S TPA
Internal Medicine, HospitalistNJ
Internal MedicineNJ

Reviews

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Frequently asked questions

How do payers reference PRANEEJA MATTA (MD)?
For PRANEEJA MATTA (MD), use NPI 1104405620 as the unique 10-digit identifier.
Active or inactive — what applies to PRANEEJA MATTA (MD)?
You should see PRANEEJA MATTA (MD) as active in CMS-hosted NPPES data.
What kind of doctor is PRANEEJA MATTA (MD)?
PRANEEJA MATTA (MD) is associated with Hospitalist Physician in the directory — Clinical services aligned with this taxonomy classification.
What locale is associated with PRANEEJA MATTA (MD)?
Directory geography for PRANEEJA MATTA (MD) centers on Camden, New Jersey.
Can I trust this NPI listing for PRANEEJA MATTA (MD)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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