NPIMap

Organization Active NPI

Zufall Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Somerville, NJ
National Provider Identifier
1053736314
Registry record updated Nov 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
22253 Issued in NJ
Legal business name
ZUFALL HEALTH CENTER, INC
Practice address
71 4TH St
Somerville, NJ 08876-3235
Phone
(908) 526-2335
NPI assigned
Feb 24, 2014
Last updated
Nov 26, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2024

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

Authorized official

Name
Imogene Anderson
Title
Cfo
Phone
(973) 328-9100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 22253 NJ Primary

Addresses

Primary practice location

71 4TH St
Somerville, NJ 08876-3235

Mailing address

18 W Blackwell St
Dover, NJ 07801-3841
Phone (973) 328-9100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140722002361 NJ Part A Provider - Federally Qualified Health Center (FQHC) 2365448461 Practice locations: Somerville, NJ

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1053736314. Details of each certification follow.

Federally qualified health center certification: CCN 311911

Legal name
ZUFALL HEALTH CENTER, INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 22, 2014
Last certification
Jul 22, 2014
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jul 3, 1991 in NJ
Enrollment address
71 4TH St
Somerville, NJ 88763235
Related CCNs
311866

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).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
31D0125526Zufall Health Center71 Fourth Street, Somerville, NJ 08876Certificate of waiverJan 21, 2028

National Provider Directory

National Provider Directory
Tax ID family
Zufall Health Center Inc16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

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

View all 15

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HGDGAA

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Eva Turbiner Individual Corporate OfficerPresident/Ceo Nov 1, 2006
Donald Costanzo Individual Corporate DirectorBoard Member Nov 6, 2006
William F Shuler Individual Corporate DirectorBoard Member Nov 6, 2006
Irma M MC Kenna Individual Corporate DirectorBoard Member Nov 6, 2006
Imogene E Anderson Individual W-2 Managing EmployeeSVP Controller Oct 1, 2024
Amy Day Weber Individual W-2 Managing EmployeeBilling Director Jan 5, 2006
Linda L Seeley Individual Corporate DirectorBoard Member Nov 6, 2006

NPI Registry JSON

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

{
    "created_epoch": "1393200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732579200000",
    "number": "1053736314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 W BLACKWELL ST",
            "city": "DOVER",
            "state": "NJ",
            "postal_code": "078013841",
            "telephone_number": "973-328-9100",
            "fax_number": "973-328-9101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 4TH ST",
            "city": "SOMERVILLE",
            "state": "NJ",
            "postal_code": "088763235",
            "telephone_number": "908-526-2335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ZUFALL HEALTH CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-24",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "IMOGENE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "973-328-9100"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NJ",
            "license": "22253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerville, NJ

Sources for this page

Verify at the official NPI Registry.