Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Choli Hartono, MD

Individual provider Nephrology Physician · NPI 1396703906

Choli Hartono, MD is a Nephrology in Hackensack, New Jersey. Graduated from Boston University School of Medicine in 1994, 32 years ago. Practices with Hackensack Meridian Health Medical Group - Specialty Care PC, a 1,897-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Massachusetts, New Jersey and New York.

Years since qualifying
32
Trained at
Boston University School of Medicine
Licensed in
MA, NJ, NY
In the registry since
2006
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

20 Prospect Ave Ste 406
Hackensack, NJ 07601-1941
Phone: (551) 996-2608
Fax: (551) 996-0826
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 505 E 70th St, New York, NY 10021-4872 — (212) 746-1578

Specialties & licences

Nephrology Physician (primary) Taxonomy 207RN0300X · Licence 25MA12080600 (NJ)
Nephrology Physician Taxonomy 207RN0300X · Licence 227574 (MA)
Nephrology Physician Taxonomy 207RN0300X · Licence 212801 (NY)

Record details

NPI number1396703906
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 3, 2006
Last updated in NPPESMarch 11, 2024
Certification dateMarch 8, 2024
Mailing address504-506 East 74th Street, 5th Floor, New York, NY 10021-3486

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNEPHROLOGY
Medical schoolBOSTON UNIVERSITY SCHOOL OF MEDICINE
Graduated 1994 (32 years in practice)
Group practice Hackensack Meridian Health Medical Group - Specialty Care Pc — 1897 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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