NPIMap

Organization Active NPI

University Hospital

  • General Acute Care Hospital
  • Newark, NJ
National Provider Identifier
1215998323
Registry record updated Mar 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
10702 Issued in NJ
Legal business name
UNIVERSITY HOSPITAL
Practice address
150 Bergen St
Newark, NJ 07103-2496
Phone
(973) 972-4300
Fax
(973) 972-6943
NPI assigned
Mar 29, 2006
Last updated
Mar 28, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2024

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

Authorized official

Name
John Gary Huck
Title
Cfo
Phone
(973) 972-0882

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 10702 NJ Primary

Addresses

Primary practice location

150 Bergen St
Newark, NJ 07103-2496

Mailing address

150 Bergen Street
Newark, NJ 07103-2496
Phone (973) 972-4300

Other identifiers 1

IdentifierTypeStateIssuer
3677001MedicaidNJ

Other names 1

  • University of Medicine and Dentistry of NJ Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100225000829 NJ Part A Provider - Hospital 5294636874 Practice locations: Newark, NJ

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1215998323. Details of each certification follow.

Hospital certification: CCN 310119

Legal name
UNIVERSITY HOSPITAL
Doing business as
UNIVERSITY OF MEDICINE AND DENTISTRY OF NJ
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jan 20, 1979
Last certification
Jun 30, 2023
Beds
519
Ownership / control type
State
Organization structure
OtherNon-profit
Incorporated
Jan 20, 1979 in NJ
Enrollment address
150 Bergen St
Newark, NJ 71032496
Main/Primary Hospital Location
Hospital subgroups
Acute care

Other NPIs with the same Medicare PAC ID 7

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

Care Compare: Hospital

Medicare Care Compare
Listed as
The University HospitalCCN 310119 · All quality measures
Overall star rating
1 of 5
Type
Acute Care Hospitals
Ownership
Government - State
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Cecile a Feldman Individual Corporate Director Jul 1, 2013
Edward Jimenez Individual W-2 Managing EmployeeCeo Jan 1, 2023
Brian L Strom Individual Corporate Director Jan 1, 2015
Tanya Freeman Individual Corporate Director Jan 1, 2015
David Molowa Individual Corporate DirectorBoard Member Jan 1, 2024
Ketlen Alsbrook Individual Corporate DirectorBoard Member Jan 1, 2024
Robert L Johnson Individual Corporate Director Jul 1, 2013
Keith Green Individual Corporate Director Jan 1, 2015
Steven Howard Landers Individual Corporate DirectorBoard Member Jan 1, 2024
John Gary Huck Individual Corporate OfficerInterim Cfo Nov 8, 2019
W-2 Managing Employee Nov 8, 2019
Operational/Managerial ControlInterim Cfo Nov 8, 2019
Mark Lattouf Individual Corporate DirectorBoard Member Jan 1, 2024
Mary O'Dowd Individual Corporate DirectorBoard Member Jan 1, 2024

Owners & managing parties with NPI records 3

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

Practitioners & affiliated clinicians

Practitioners 249

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 249

Affiliated clinicians 513

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 513

NPI Registry JSON

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

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711584000000",
    "number": "1215998323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 BERGEN STREET",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032496",
            "telephone_number": "973-972-4300",
            "fax_number": "973-972-9129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 BERGEN ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032496",
            "telephone_number": "973-972-4300",
            "fax_number": "973-972-6943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-29",
        "last_updated": "2024-03-28",
        "certification_date": "2024-02-21",
        "status": "A",
        "authorized_official_last_name": "HUCK",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "GARY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "973-972-0882"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NJ",
            "license": "10702",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3677001",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "University of Medicine and Dentistry of NJ",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "University of Medicine and Dentistry of NJ",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.