NPIMap

Organization Active NPI

North Hudson Community Action Corporation

  • Federally Qualified Health Center (FQHC)
  • Secaucus, NJ
National Provider Identifier
1043465057
Registry record updated Jan 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
NORTH HUDSON COMMUNITY ACTION CORPORATION
Practice address
55 Meadowlands Pkwy FL 2
Secaucus, NJ 07094-2977
Phone
(201) 210-0200
NPI assigned
Nov 19, 2008
Organization subpart
Yes
Parent organization
NORTH HUDSON COMMUNITY ACTION CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 26, 2023

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

Authorized official

Name
Christopher F Irizarry
Title
President/Ceo
Phone
(201) 866-2388

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

55 Meadowlands Pkwy FL 2
Secaucus, NJ 07094-2977

Mailing address

5301 Broadway
West New York, NJ 07093-2622
Phone (201) 866-9320

Other identifiers 1

IdentifierTypeStateIssuer
0022713MedicaidNJ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090529000045 NJ Part A Provider - Federally Qualified Health Center (FQHC) 6103887997 Practice locations: Secaucus, NJ

Federally qualified health center certification: CCN 311850

Legal name
NORTH HUDSON COMMUNITY ACTION CORPORATION
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 29, 2004
Last certification
Dec 29, 2004
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Oct 8, 1965 in NJ
Enrollment address
55 Meadowlands Pkwy
FL 2
Secaucus, NJ 70942977
Related CCNs
311829

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

Other NPIs with the same Medicare PAC ID 9

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

National Provider Directory

National Provider Directory
Tax ID family
North Hudson Community Action Corporation14 organizations share this tax ID, including this one
Part of
North Hudson Community Action Corporation

Other organizations with this tax ID 13

Organizations that report the same tax identification number in the National Provider Directory.

View all 13

Locations

25 E Salem St
Ste F16
Hackensack, NJ 07601

25 E Salem St
Fl 6
Hackensack, NJ 07601

1116 43rd St
North Bergen, NJ 07047
Phone (201) 330-2632

Ownership & related parties

All disclosed owners & managing parties 20

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

NameRoleSinceShare
Pura Cabrera Individual Corporate DirectorBoard Member May 8, 2015
Juana Malave Individual Corporate DirectorBoard Member Jan 20, 2015
Joseph Muniz Individual Corporate DirectorChairperson-Board of Directors Apr 25, 2011
Maria Vila Individual Corporate DirectorBoard Member Jul 31, 2013
Michael Shababb Individual Corporate OfficerCfo Jul 1, 1994
W-2 Managing EmployeeCfo (Chief Financial Official) May 8, 2015
Joan Woods Individual Corporate DirectorBoard Member-Secretary Mar 4, 2013
Silverio Vega Individual Corporate DirectorBoard Member Sep 16, 2014
Kim Nicoliello Individual Corporate DirectorBoard Member Mar 18, 2014
Christina McLellan Individual Corporate DirectorBoard Member Nov 28, 2013
Erika Zucconi Individual Corporate DirectorBoard Member-Vice Chairperson Dec 18, 2006
Mariano Pellegrino Individual Corporate DirectorBoard Member Jul 30, 2012
Marisol Acosta Individual Corporate DirectorBoard Member Oct 29, 2012
Robert Divincent Individual Corporate DirectorBoard Member Sep 16, 2014
Lisa Snedeker Individual Corporate DirectorBoard Member Feb 24, 2015
Victor Grullon Individual Corporate DirectorBoard Member Dec 16, 2013
Wayne Cook Individual Corporate DirectorBoard Member Nov 25, 2014
Hilda R Roque Dieguez Individual Corporate DirectorBoard Member Oct 31, 2011
Linda Habermann Individual Corporate DirectorBoard Member Mar 18, 2014
Ulysses Isa Individual Corporate DirectorBoard Member Jun 29, 2009
Rosemary Roque Individual Corporate DirectorBoard Member Nov 29, 2010

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
North Hudson Community Action CorporationHarrison, NJ, CCN 311931 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Feb 1, 2016
Feb 1, 2016

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1227052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674691200000",
    "number": "1043465057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5301 BROADWAY",
            "city": "WEST NEW YORK",
            "state": "NJ",
            "postal_code": "070932622",
            "telephone_number": "201-866-9320",
            "fax_number": "201-392-9084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 MEADOWLANDS PKWY FL 2",
            "city": "SECAUCUS",
            "state": "NJ",
            "postal_code": "070942977",
            "telephone_number": "201-210-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH HUDSON COMMUNITY ACTION CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTH HUDSON COMMUNITY ACTION CORPORATION",
        "enumeration_date": "2008-11-19",
        "last_updated": "2023-01-26",
        "certification_date": "2023-01-26",
        "status": "A",
        "authorized_official_last_name": "IRIZARRY",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "201-866-2388"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0022713",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Secaucus, NJ

Sources for this page

Verify at the official NPI Registry.