Doctor'S Office of West Caldwell LLC
Organization Active NPI Urgent Care Clinic/Center · West Caldwell, NJ
NPI 1144524786 · NPPES record last updated Apr 13, 2023
Key facts
- NPI
- 1144524786
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Urgent Care Clinic/Center 261QU0200X
- Legal business name
- DOCTOR'S OFFICE OF WEST CALDWELL LLC
- Practice address
- 556 Passaic Ave
West Caldwell, NJ 07006-7449 - Phone
- (973) 808-2273
- Fax
- (973) 808-2287
- NPI assigned
- Dec 22, 2010
- Organization subpart
- No
Authorized official
- Name
- Dr. Anthony R Ruvo, MD
- Title
- President
- Phone
- (845) 565-3700
Practitioners 101
-
Heraa Chaudhry, MD
-
Mary Friel, M.D.
-
Damilola Ajakaye, PA
-
Adriana Nicole Deschamps, PA-C
-
Michael D Freeman, P.A.
-
Jordan Michael Greenberg, PA-C
-
Zhanna Jones, PHYSICIAN ASSISTANT
-
Leah A Law, PA
-
Hyesun Lee, M.S, P.A.-C
-
Gina Marie Miranda, PA-C
-
Punam Patel, P.A.
-
Ricardo J Pinzon, P.A.
-
Brennan M Ross, PA-C
-
Andres Vega, PA-C
-
Christopher Walden, PA-C
-
Ekata H Rushi, PHYSICIAN ASSISTANT
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 31D2010391 | The Doctor'S Office of West Caldwell | Certificate of waiver | Jul 26, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110329000053 | NJ | Part B Supplier - Clinic/Group Practice | 7416130448 |
Receives reassigned benefits from 99 practitioners Practice locations: West Caldwell, NJ |
National Provider Directory
Locations
210 Meadowlands Pkwy
Secaucus, NJ 07094
Phone (201) 330-9090
800 Bloomfield Ave
West Caldwell, NJ 07006
556 Passaic Ave
West Caldwell, NJ 07006
Phone (973) 808-2273
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urgent Care Clinic/Center | 261QU0200X | Yes |
Addresses
Primary practice location
556 Passaic Ave
West Caldwell, NJ 07006-7449
Mailing address
484 Temple Hill Rd
Suite 102
New Windsor, NY 12553-5557
Phone (845) 565-3700
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0637246 | Medicaid | NJ |
Other providers in West Caldwell, NJ
- Dedicated Home Care Services
- Arthur J. Delorenzo
- Megan C Deoliveira
- Elizabeth Devaney
- Dimension Health LLC
- Nino Domingo
- Darryl Donlin
- Jacqueline Dorrity
- Dr. Coach Kelli Physical Therapy
- Karen Ann Dreyer
All providers in West Caldwell, NJ · Urgent Care Clinic/Center in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 13, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.