CCG Medical Group LLC
Organization Active NPI Specialist · Springfield, NJ
NPI 1245954254 · NPPES record last updated Jul 7, 2025
Key facts
- NPI
- 1245954254
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Specialist 174400000X
- Legal business name
- CCG MEDICAL GROUP LLC
- Practice address
- 673 Morris Ave Ste 201
Springfield, NJ 07081-1512 - Phone
- (973) 759-9000
- NPI assigned
- Oct 3, 2022
- Organization subpart
- No
Authorized official
- Name
- Clifford Sales, MD
- Title
- Managing Business Partner
- Phone
- (973) 759-9000
Other NPIs on the same Medicare enrollment 1
Other NPIs with the same Medicare PAC ID 1
Practitioners 34
-
Michael D Addis, MD
-
Bruce J. Brener, MD
-
Andrew Cha, D.O.
-
Elizabeth Coll, NP
-
Daniel Fremed, M.D.
-
Raymond J Holmes, MD
-
Jonathan Lee, MD
-
Jonathan A Levison, M.D.
-
Elena Macias, PA
-
Deirdre A McGagh, R-PAC
-
Michael Ombrellino, M.D.
-
Michael A Pontoriero, M.D.
-
Combiz Rezayat, M.D.
-
Clifford M Sales, MD
-
Emily Elizabeth Simmons, APN-C
-
Cindy Sturt, MD
-
Bijal Parmar, PA
-
Cindy Ann Bowman, PA-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NJ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230106002797 | NJ | Part B Supplier - Clinic/Group Practice | 0648640680 |
Receives reassigned benefits from 31 practitioners Practice locations: Westfield, NJ; Springfield, NJ; Hoboken, NJ; Shrewsbury, NJ; Morristown, NJ; Denville, NJ; Clifton, NJ |
| O20241210004141 | NJ | Part B Supplier - Ambulatory Surgical Center | 0648640680 |
Receives reassigned benefits from 18 practitioners 1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Westfield, NJ |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist |
174400000X | Yes | ||
| Multi-Specialty Clinic/Center | 261QM1300X |
Addresses
Primary practice location
673 Morris Ave Ste 201
Springfield, NJ 07081-1512
Mailing address
673 Morris Ave Ste 201
Springfield, NJ 07081-1512
Phone (973) 759-9000
Other providers in Springfield, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 7, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.