Organization Active NPI

Qualcare Medi Center, PA

  • Specialist
  • Rahway, NJ
National Provider Identifier
1265627426
Registry record updated Sep 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
25MA06993300 Issued in NJ
Legal business name
QUALCARE MEDI CENTER, PA
Practice address
1600 Saint Georges Ave
Suite 216
Rahway, NJ 07065-2764
Phone
(732) 396-0777
Fax
(732) 936-9222
NPI assigned
Sep 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2007

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

Authorized official

Name
Dr. George W Long, MDNPI 1952360273
Title
Physician
Phone
(732) 396-0777

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 25MA06993300 NJ Primary

Addresses

Primary practice location

1600 Saint Georges Ave
Suite 216
Rahway, NJ 07065-2764

Mailing address

1600 Saint Georges Ave
Suite 216
Rahway, NJ 07065-2764
Phone (732) 396-0777

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120302000375 NJ Part B Supplier - Clinic/Group Practice 2264691724 Receives reassigned benefits from 1 practitioner
Practice locations: Edison, NJ

National Provider Directory

National Provider Directory

Locations

2 Lincoln Hwy
Ste 411
Edison, NJ 08820
Phone (732) 396-0777

1600 Saint Georges Ave
Ste 216
Rahway, NJ 07065
Phone (732) 381-0121

Practitioners & affiliated clinicians

Practitioners 1

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": "1189468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189468800000",
    "number": "1265627426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 SAINT GEORGES AVE",
            "address_2": "SUITE 216",
            "city": "RAHWAY",
            "state": "NJ",
            "postal_code": "070652764",
            "telephone_number": "732-396-0777",
            "fax_number": "732-936-9222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SAINT GEORGES AVE",
            "address_2": "SUITE 216",
            "city": "RAHWAY",
            "state": "NJ",
            "postal_code": "070652764",
            "telephone_number": "732-396-0777",
            "fax_number": "732-936-9222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUALCARE MEDI CENTER, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-11",
        "last_updated": "2007-09-11",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "732-396-0777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NJ",
            "license": "25MA06993300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rahway, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2007; 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.