Organization Active NPI

Paterson Community Clinic, PA

  • Specialist
  • Paterson, NJ
National Provider Identifier
1154375186
Registry record updated Mar 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MA63194 Issued in NJ
Legal business name
PATERSON COMMUNITY CLINIC, PA
Practice address
37 Crooks Ave
Paterson, NJ 07503-1401
Phone
(973) 685-9922
Fax
(973) 685-9920
NPI assigned
May 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2025

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

Authorized official

Name
Dr. Mahmoud Aqel, MDNPI 1821067786
Title
Owner
Phone
(973) 523-9090

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
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X MA63194 NJ Primary

Addresses

Primary practice location

37 Crooks Ave
Paterson, NJ 07503-1401

Mailing address

37 Crooks Ave
Paterson, NJ 07503-1401
Phone (973) 685-9922

Other identifiers 1

IdentifierTypeStateIssuer
6849709MedicaidNJ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040126000243 NJ Part B Supplier - Clinic/Group Practice 1557263936 Receives reassigned benefits from 1 practitioner
Practice locations: Paterson, NJ

National Provider Directory

National Provider Directory

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": "1148256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742169600000",
    "number": "1154375186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 CROOKS AVE",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075031401",
            "telephone_number": "973-685-9922",
            "fax_number": "973-685-9920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 CROOKS AVE",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075031401",
            "telephone_number": "973-685-9922",
            "fax_number": "973-685-9920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATERSON COMMUNITY CLINIC, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-22",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-17",
        "status": "A",
        "authorized_official_last_name": "AQEL",
        "authorized_official_first_name": "MAHMOUD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-523-9090",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "NJ",
            "license": "MA63194",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6849709",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Paterson, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.