NPIMap

Organization Active NPI

Ambulatory Pain and Disability Management Center LLC

  • Ambulatory Surgical Clinic/Center
  • Jersey City, NJ
National Provider Identifier
1093311276
Registry record updated Oct 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
AMBULATORY PAIN AND DISABILITY MANAGEMENT CENTER LLC
Practice address
Ambulatory Pain and Disability Management Center LLC
191 Palisade Avenue
Jersey City, NJ 07306-0730
Phone
(201) 656-4324
NPI assigned
Dec 11, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2021

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

Authorized official

Name
Monica Mehta, MDNPI 1427099985
Title
Administrator
Phone
(201) 653-5044

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

Ambulatory Pain and Disability Management Center LLC
191 Palisade Avenue
Jersey City, NJ 07306-0730

Mailing address

Ambulatory Pain and Disability Management Center LLC
191 Palisade Avenue
Jersey City, NJ 07306
Phone (201) 656-4324

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210923000006 NJ Part B Supplier - Ambulatory Surgical Center 0446657142 Practice locations: Jersey City, NJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 34

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

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1607644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634774400000",
    "number": "1093311276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "AMBULATORY PAIN AND DISABILITY MANAGEMENT CENTER LLC",
            "address_2": "191 PALISADE AVENUE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "07306",
            "telephone_number": "201-656-4324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "AMBULATORY PAIN AND DISABILITY MANAGEMENT CENTER LLC",
            "address_2": "191 PALISADE AVENUE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073060730",
            "telephone_number": "201-656-4324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMBULATORY PAIN AND DISABILITY MANAGEMENT CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-11",
        "last_updated": "2021-10-21",
        "certification_date": "2021-10-21",
        "status": "A",
        "authorized_official_last_name": "MEHTA",
        "authorized_official_first_name": "MONICA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "201-653-5044",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jersey City, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.