Organization Active NPI

Immedicenter Totowa

  • Family Medicine Physician
  • Totowa, NJ
National Provider Identifier
1174629943
Registry record updated Apr 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
IMMEDICENTER TOTOWA
Doing business as
Totowa Pimary Care Center
Practice address
160 Union Blvd
Ste 3
Totowa, NJ 07512-2666
Phone
(973) 790-0090
Fax
(973) 790-6070
NPI assigned
Sep 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2024

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

Authorized official

Name
Mrs. Frank Lima, MD
Title
Owner
Phone
(973) 794-8345

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

160 Union Blvd
Ste 3
Totowa, NJ 07512-2666

Mailing address

160 Union Blvd
Ste 3
Totowa, NJ 07512-2666
Phone (973) 790-0090

Other identifiers 1

IdentifierTypeStateIssuer
CG1322OtherNJRAILROAD MEDICARE

Other names 1

  • Totowa Pimary Care Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040420000209 NJ Part B Supplier - Clinic/Group Practice 6507851359 Receives reassigned benefits from 1 practitioner
Practice locations: Totowa, NJ

National Provider Directory

National Provider Directory

Locations

160 Union Blvd
Totowa, NJ 07512
Phone (973) 790-0090

Practitioners & affiliated clinicians

Practitioners 2

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": "1158364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712275200000",
    "number": "1174629943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 UNION BLVD",
            "address_2": "STE 3",
            "city": "TOTOWA",
            "state": "NJ",
            "postal_code": "075122666",
            "telephone_number": "973-790-0090",
            "fax_number": "973-790-6070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 UNION BLVD",
            "address_2": "STE 3",
            "city": "TOTOWA",
            "state": "NJ",
            "postal_code": "075122666",
            "telephone_number": "973-790-0090",
            "fax_number": "973-790-6070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMMEDICENTER TOTOWA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-16",
        "last_updated": "2024-04-05",
        "certification_date": "2023-07-25",
        "status": "A",
        "authorized_official_last_name": "LIMA",
        "authorized_official_first_name": "FRANK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-794-8345",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CG1322",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Totowa Pimary Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Totowa, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2024; 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.