Organization Active NPI

Metropolitan Community Medical Care LLC

  • Primary Care Clinic/Center
  • Elizabeth, NJ
National Provider Identifier
1164615126
Registry record updated Oct 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
25MA07280100 Issued in NJ
Legal business name
METROPOLITAN COMMUNITY MEDICAL CARE LLC
Practice address
500 Westfield Ave
Elizabeth, NJ 07208-1642
Phone
(908) 994-1500
Fax
(908) 994-0035
NPI assigned
Aug 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2010

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

Authorized official

Name
Mr. Edward Rakler, PA-C
Title
Physician Assistant
Phone
(908) 994-1500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 25MA07280100 NJ Primary

Addresses

Primary practice location

500 Westfield Ave
Elizabeth, NJ 07208-1642

Mailing address

500 Westfield Ave
Elizabeth, NJ 07208-1642
Phone (908) 994-1500

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": "1187827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286496000000",
    "number": "1164615126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 WESTFIELD AVE",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072081642",
            "telephone_number": "908-994-1500",
            "fax_number": "908-994-0035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 WESTFIELD AVE",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072081642",
            "telephone_number": "908-994-1500",
            "fax_number": "908-994-0035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METROPOLITAN COMMUNITY MEDICAL CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-23",
        "last_updated": "2010-10-08",
        "status": "A",
        "authorized_official_last_name": "RAKLER",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "PHYSICIAN ASSISTANT",
        "authorized_official_telephone_number": "908-994-1500",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NJ",
            "license": "25MA07280100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabeth, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.