NPIMap

Organization Active NPI

United Medical PC

  • Internal Medicine Physician
  • Clifton, NJ
National Provider Identifier
1215236047
Registry record updated Mar 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA04594000 Issued in NJ
Legal business name
UNITED MEDICAL PC
Practice address
1117 Route 46
Suite 205
Clifton, NJ 07013-2449
Phone
(973) 471-0981
Fax
(973) 471-5818
NPI assigned
Mar 18, 2011
Last updated
Mar 18, 2011By the provider in NPPES
Organization subpart
Yes
Parent organization
UNITED MEDICAL PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 18, 2011

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

Authorized official

Name
Dr. Byong Park, M.D.NPI 1235104506
Title
President & Medical Director
Phone
(201) 460-0063

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MA04594000 NJ Primary
Hematology & Oncology Physician 207RH0003X 25MA03065000 NJ

Addresses

Primary practice location

1117 Route 46
Suite 205
Clifton, NJ 07013-2449

Mailing address

612 Rutherford Ave
Lyndhurst, NJ 07071-1217
Phone (201) 460-0063

Other identifiers 1

IdentifierTypeStateIssuer
0251623MedicaidNJ

National Provider Directory

National Provider Directory
Tax ID family
United Medical PC6 organizations share this tax ID, including this one
Part of
United Medical PC

Other organizations with this tax ID 5

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1300406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300406400000",
    "number": "1215236047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 RUTHERFORD AVE",
            "city": "LYNDHURST",
            "state": "NJ",
            "postal_code": "070711217",
            "telephone_number": "201-460-0063",
            "fax_number": "201-460-1684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1117 ROUTE 46",
            "address_2": "SUITE 205",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070132449",
            "telephone_number": "973-471-0981",
            "fax_number": "973-471-5818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNITED MEDICAL PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UNITED MEDICAL PC",
        "enumeration_date": "2011-03-18",
        "last_updated": "2011-03-18",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "BYONG",
        "authorized_official_title_or_position": "PRESIDENT & MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "201-460-0063",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA04594000",
            "primary": true
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NJ",
            "license": "25MA03065000",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0251623",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2011; 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.