Organization Active NPI

Lafayette Medical Center, LLC

  • Internal Medicine Physician
  • Newark, NJ
National Provider Identifier
1144307166
Registry record updated Jul 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
LAFAYETTE MEDICAL CENTER, LLC
Practice address
390 New York Ave
Newark, NJ 07105-3125
Phone
(973) 344-3518
Fax
(973) 344-1167
NPI assigned
Nov 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2010

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

Authorized official

Name
Renee Julie Cabaleiro, MDNPI 1407907256
Title
Doctor
Phone
(973) 344-3518

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Gastroenterology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0100X

Addresses

Primary practice location

390 New York Ave
Newark, NJ 07105-3125

Mailing address

390 New York Ave
Newark, NJ 07105-3125
Phone (973) 344-3518

Other identifiers 1

IdentifierTypeStateIssuer
2018802MedicaidNJ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050323000153 NJ Part B Supplier - Clinic/Group Practice 3476509555 Receives reassigned benefits from 2 practitioners
Practice locations: Newark, NJ

National Provider Directory

National Provider Directory

Locations

338 Lafayette St
Newark, NJ 07105
Phone (973) 344-3518

390 New York Ave
Newark, NJ 07105
Phone (973) 344-3518

Practitioners & affiliated clinicians

Practitioners 5

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": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278892800000",
    "number": "1144307166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 NEW YORK AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071053125",
            "telephone_number": "973-344-3518",
            "fax_number": "973-344-1167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 NEW YORK AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071053125",
            "telephone_number": "973-344-3518",
            "fax_number": "973-344-1167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAFAYETTE MEDICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2010-07-12",
        "status": "A",
        "authorized_official_last_name": "CABALEIRO",
        "authorized_official_first_name": "RENEE",
        "authorized_official_middle_name": "JULIE",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "973-344-3518",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2018802",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2010; 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.