Beth Israel Hospital Association

Primary specialty

General Acute Care HospitalTaxonomy code 282N00000X

License

11604 Issued in NJ

Legal business name

BETH ISRAEL HOSPITAL ASSOCIATION

Doing business as

PBI Regional Medical Center

Practice address

350 Boulevard
Passaic, NJ 07055-2840

Phone

(973) 365-4300

NPI assigned

Sep 15, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Daniel K Willis

Title

Director Manged Care

Phone

(973) 365-4556

Specialties & licenses 1

Addresses

Other names 1

• PBI Regional Medical Center Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1164528634. Details of each certification follow.

• CCN 310020 Hospital · Terminated · Name & address match · Details

Hospital certification: CCN 310020

Legal name

PBI REGIONAL MEDICAL CENTER

Certification status

Terminated Voluntary: merger or closure, Mar 1, 2007

Provider type (POS)

Hospital – Short-term

Participating since

Jul 1, 1966

Last certification

Aug 15, 1996

Beds

223

Ownership / control type

Private (not for profit)

Facility address

350 Boulevard
Passaic, NJ 07055

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1164528634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 BOULEVARD",
            "city": "PASSAIC",
            "state": "NJ",
            "postal_code": "070552840",
            "telephone_number": "973-365-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 BOULEVARD",
            "city": "PASSAIC",
            "state": "NJ",
            "postal_code": "070552840",
            "telephone_number": "973-365-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETH ISRAEL HOSPITAL ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILLIS",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "DIRECTOR MANGED CARE",
        "authorized_official_telephone_number": "973-365-4556",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NJ",
            "license": "11604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PBI Regional Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Valerie Marie Bethke, LCSW
• Beyond Home Health Services of NJ
• Jayashree Bhatnagar, OTR
• Sunil Bhatta, M.D.
• Faigie T Bier, MS, OTR/L

• General Acute Care Hospital in Passaic, NJ
• Providers in Passaic, NJ by specialty
• General Acute Care Hospital in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.