NPIMap

Organization Active NPI

Newark Community Health Centers,Inc.

  • Federally Qualified Health Center (FQHC)
  • East Orange, NJ
National Provider Identifier
1194996645
Registry record updated Mar 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
80194 Issued in NJ
Legal business name
NEWARK COMMUNITY HEALTH CENTERS,INC.
Practice address
444 William St
East Orange, NJ 07017-2213
Phone
(973) 675-1900
Fax
(973) 675-4021
NPI assigned
Mar 12, 2008
Last updated
Mar 8, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
NEWARK COMMUNITY HEALTH CENTERS,INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 8, 2024

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

Authorized official

Name
Pamela Clarke
Title
Preseident/Ceo
Phone
(973) 483-1300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 80194 NJ Primary

Addresses

Primary practice location

444 William St
East Orange, NJ 07017-2213

Mailing address

444 William St
East Orange, NJ 07017-2213
Phone (973) 675-1900

Other identifiers 1

IdentifierTypeStateIssuer
0409839MedicaidNJ

Other names 1

  • East Orange Primary Care Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081027000284 NJ Part A Provider - Federally Qualified Health Center (FQHC) 2163334665 Practice locations: East Orange, NJ

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1194996645. Details of each certification follow.

Federally qualified health center certification: CCN 311821

Legal name
NEWARK COMMUNITY HEALTH CENTERS INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 1, 1992
Last certification
Jan 1, 1992
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Enrollment address
444 William St
East Orange, NJ 70172213

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Newark Community Health Centers7 organizations share this tax ID, including this one
Part of
Newark Community Health Centers

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

444 William St
East Orange, NJ 07017
Phone (973) 675-1900

Ownership & related parties

All disclosed owners & managing parties 18

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Marie Carter Individual Corporate Director Jul 8, 2013
W-2 Managing Employee Apr 7, 2015
Jose Contreras Individual Other Apr 30, 2015
Tomas Bacalzo Individual Corporate Officer Apr 7, 2015
W-2 Managing Employee Apr 7, 2015
Nicole a Waryn Individual W-2 Managing Employee Oct 15, 2025
Haniel Rosemond Individual W-2 Managing EmployeeBoard Member Dec 18, 2023
Sonya Hardaway Individual W-2 Managing Employee Apr 30, 2015
Arthur Nisbeth Individual Corporate Director Nov 10, 2022
Carmen a Lopez Individual Other Apr 7, 2015
Pamela Clarke Individual Corporate Officer Nov 1, 2010
W-2 Managing Employee Apr 7, 2015
Jacqueline Mompoint Individual Corporate Director Nov 10, 2022
Edward Robinson Individual Corporate Director Nov 10, 2022
Thomas M Ransome Individual W-2 Managing EmployeeBoard Member Dec 18, 2023
Omar M Bey Individual Corporate OfficerCeo Nov 1, 2010
Yewande Efodili Individual Corporate DirectorDirector of Patient Financial SE Jun 17, 2025
W-2 Managing EmployeeDirector of Patient Financial SE Jun 17, 2025
Patricia Vallejo Individual Corporate Director Nov 10, 2022
Cassandra Savoy Individual W-2 Managing EmployeeBoard Member May 1, 2023
Alo Gold Individual Corporate Director Nov 10, 2022
Michael L Moore Individual Corporate Director Nov 10, 2022
Other Apr 7, 2015

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 34

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1205280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709856000000",
    "number": "1194996645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 WILLIAM ST",
            "city": "EAST ORANGE",
            "state": "NJ",
            "postal_code": "070172213",
            "telephone_number": "973-675-1900",
            "fax_number": "973-675-4021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 WILLIAM ST",
            "city": "EAST ORANGE",
            "state": "NJ",
            "postal_code": "070172213",
            "telephone_number": "973-675-1900",
            "fax_number": "973-675-4021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEWARK COMMUNITY HEALTH CENTERS,INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NEWARK COMMUNITY HEALTH CENTERS,INC.",
        "enumeration_date": "2008-03-12",
        "last_updated": "2024-03-08",
        "certification_date": "2024-03-07",
        "status": "A",
        "authorized_official_last_name": "CLARKE",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_title_or_position": "PRESEIDENT/CEO",
        "authorized_official_telephone_number": "973-483-1300"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NJ",
            "license": "80194",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0409839",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "East Orange Primary Care",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in East Orange, NJ

Sources for this page

Verify at the official NPI Registry.