Organization Active NPI

Living Springs Women'S Care, LLC

  • Obstetrics Physician
  • Passaic, NJ
National Provider Identifier
1114545241
Registry record updated Mar 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics PhysicianTaxonomy code 207VX0000X
Legal business name
LIVING SPRINGS WOMEN'S CARE, LLC
Practice address
916 Main Ave Ste 2C
Passaic, NJ 07055-8545
Phone
(973) 200-2794
NPI assigned
Jul 6, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2023

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

Authorized official

Name
Abiola Mustafa
Title
Manager
Phone
(973) 200-2794

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207VX0000X Primary

Addresses

Primary practice location

916 Main Ave Ste 2C
Passaic, NJ 07055-8545

Mailing address

916 Main Ave Ste 2C
Passaic, NJ 07055-8545

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL www.livingspringswomenscare.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200818001244 NJ Part B Supplier - Clinic/Group Practice 4880010107 Receives reassigned benefits from 1 practitioner
Practice locations: North Arlington, NJ; Passaic, NJ

National Provider Directory

National Provider Directory
Tax ID family
Living Springs Women'S Care2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

312 Belleville Tpke
Ste 2B
North Arlington, NJ 07031
Phone (201) 991-0211

916 Main Ave
Ste 2C
Passaic, NJ 07055
Phone (973) 200-2794

916 Main Ave
Fl 2
Passaic, NJ 07055

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/21692/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1593993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679616000000",
    "number": "1114545241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "916 MAIN AVE STE 2C",
            "city": "PASSAIC",
            "state": "NJ",
            "postal_code": "070558545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "916 MAIN AVE STE 2C",
            "city": "PASSAIC",
            "state": "NJ",
            "postal_code": "070558545",
            "telephone_number": "973-200-2794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVING SPRINGS WOMEN'S CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-06",
        "last_updated": "2023-03-24",
        "certification_date": "2023-03-24",
        "status": "A",
        "authorized_official_last_name": "MUSTAFA",
        "authorized_official_first_name": "ABIOLA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "973-200-2794"
    },
    "taxonomies": [
        {
            "code": "207VX0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.livingspringswomenscare.com",
            "affiliation": "N",
            "endpointDescription": "Website Address",
            "address_1": "916 Main Ave Ste 2C",
            "city": "Passaic",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "070558545",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Passaic, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2023; 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.