NPIMap

Organization Active NPI

Newark Beth Israel Medical Center Inc

Doing business as Newark Beth Israel Medical Center

  • Psychiatric Hospital Unit
  • Newark, NJ
National Provider Identifier
1043457955
Registry record updated Sep 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
License
10709 Issued in NJ
Legal business name
NEWARK BETH ISRAEL MEDICAL CENTER INC
Doing business as
Newark Beth Israel Medical Center
Practice address
201 Lyons Ave
Newark, NJ 07112-2027
Phone
(732) 923-5000
Fax
(732) 923-2272
NPI assigned
Jan 14, 2009
Last updated
Sep 30, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
RWJ BARNABAS HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 30, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Darrell Terry
Title
Ceo
Phone
(923) 926-7850

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X
Psychiatric Hospital Unit 273R00000X 10709 NJ Primary
General Acute Care Hospital 282N00000X
Psychiatric Hospital 283Q00000X

Addresses

Primary practice location

201 Lyons Ave
Newark, NJ 07112-2027

Mailing address

201 Lyons Ave
Newark, NJ 07112-2027
Phone (732) 923-5000

Other identifiers 1

IdentifierTypeStateIssuer
4135008MedicaidNJ

Other names 1

  • Newark Beth Israel Medical Center Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address newarkbethisrael@direct.rwjbh.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210525002724 NJ Part A Provider - Hospital 3173437464 Practice locations: Newark, NJ

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1043457955. Details of each certification follow.

Hospital certification: CCN 31S002

Legal name
NEWARK BETH ISRAEL MEDICAL CENTER INC
Doing business as
NEWARK BETH ISRAEL MEDICAL CENTER
Organization structure
CorporationNon-profit
Enrollment address
201 Lyons Ave
Newark, NJ 71122027
Hospital Psychiatric Unit
Hospital subgroups
Psychiatric unit

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Member organizations 6

Organizations listed as members of this organization in the National Provider Directory.

Locations

516 Bergen St
Newark, NJ 07108
Phone (201) 633-5773

Ownership & related parties

All disclosed owners & managing parties 5

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Richard Henwood Individual Corporate Director Jan 1, 2012
W-2 Managing EmployeeVice President of Corporate Reim Jan 1, 2012
RWJ Barnabas Health Inc Organization, West Orange, NJ Corporation, Non-profit, Chain home office Operational/Managerial Control Apr 1, 2016
Mark E Manigan Individual Corporate Officer Jan 1, 2023
Darrell Terry Individual Corporate Officer Jan 1, 2021
Deborah Dente Individual Corporate Officer Jan 1, 2022

Facilities with the same owner 20

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 20

Practitioners & affiliated clinicians

Practitioners 83

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 83

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1231891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727654400000",
    "number": "1043457955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 LYONS AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071122027",
            "telephone_number": "732-923-5000",
            "fax_number": "973-926-8371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 LYONS AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071122027",
            "telephone_number": "732-923-5000",
            "fax_number": "732-923-2272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEWARK BETH ISRAEL MEDICAL CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RWJ BARNABAS HEALTH",
        "enumeration_date": "2009-01-14",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A",
        "authorized_official_last_name": "TERRY",
        "authorized_official_first_name": "DARRELL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "923-926-7850",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "NJ",
            "license": "10709",
            "primary": true
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4135008",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "newarkbethisrael@direct.rwjbh.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "201 Lyons Ave",
            "city": "Newark",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "071122027",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Newark Beth Israel Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Newark Beth Israel Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.