NPIMap

Organization Active NPI

Clinical Healthcare Associates of New Jersey Specialty Practices PC

  • Internal Medicine Physician
  • Bala Cynwyd, PA
National Provider Identifier
1104630714
Registry record updated Nov 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
CLINICAL HEALTHCARE ASSOCIATES OF NEW JERSEY SPECIALTY PRACTICES PC
Practice address
150 Monument Rd FL 4
Bala Cynwyd, PA 19004-1702
Phone
(610) 902-1738
NPI assigned
Feb 4, 2025
Last updated
Nov 21, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2025

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

Authorized official

Name
Stacy Greco
Title
Enrollment Supervisor
Phone
(223) 341-8516

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

150 Monument Rd FL 4
Bala Cynwyd, PA 19004-1702

Mailing address

150 Monument Rd FL 4
Bala Cynwyd, PA 19004-1702

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250721000851 NJ Part B Supplier - Clinic/Group Practice 9335655026 Receives reassigned benefits from 53 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Woodbury Heights, NJ; Voorhees, NJ; Trenton, NJ; Sewell, NJ; Princeton, NJ; Plainsboro, NJ; Cherry Hill, NJ

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Clinical Healthcare Associates of New Jersey Specialty Practices PC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Practitioners & affiliated clinicians

Practitioners 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1738627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763683200000",
    "number": "1104630714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 MONUMENT RD FL 4",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190041702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 MONUMENT RD FL 4",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190041702",
            "telephone_number": "610-902-1738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICAL HEALTHCARE ASSOCIATES OF NEW JERSEY SPECIALTY PRACTICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-04",
        "last_updated": "2025-11-21",
        "certification_date": "2025-11-21",
        "status": "A",
        "authorized_official_last_name": "GRECO",
        "authorized_official_first_name": "STACY",
        "authorized_official_title_or_position": "ENROLLMENT SUPERVISOR",
        "authorized_official_telephone_number": "223-341-8516"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bala Cynwyd, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2025; 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.