NPIMap

Organization Active NPI

City of Newark

Doing business as Newark Department of Health and Community Wellness

  • Community Health Clinic/Center
  • Newark, NJ
National Provider Identifier
1356561278
Registry record updated Apr 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
Legal business name
CITY OF NEWARK
Doing business as
Newark Department of Health and Community Wellness
Practice address
110 William St
Newark, NJ 07102-1304
Phone
(973) 733-7558
NPI assigned
Apr 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2024

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

Authorized official

Name
Ketlen Alsbrook
Title
Ceo/Director
Phone
(973) 733-5310

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X Primary

Addresses

Primary practice location

110 William St
Newark, NJ 07102-1304

Mailing address

110 William St
Newark, NJ 07102-1304
Phone (973) 733-7558

Other names 1

  • Newark Department of Health and Community Wellness Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100113000101 NJ Part B Supplier - Clinic/Group Practice 8123169182 Receives reassigned benefits from 24 practitioners
1 other NPI on this enrollment
Practice locations: Newark, NJ

Other NPIs with the same Medicare PAC ID 3

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

  • City of Newark

    dba Newark Department of Health and Community Welllness

    • Federally Qualified Health Center (FQHC)
    • Newark, NJ
    • NPI 1295958908

    8123169182

    Same PAC ID
  • City of Newark

    dba Newark Department of Health and Community Wellness

    • Community Health Clinic/Center
    • Newark, NJ
    • NPI 1376976704

    8123169182

    Same PAC ID
  • City of Newark

    dba Newark Department of Health and Community Wellness/Mary Eliza Mahoney

    • Federally Qualified Health Center (FQHC)
    • Newark, NJ
    • NPI 1972206258

    8123169182

    Same PAC ID

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

  • City of Newark

    dba Newark Department of Health and Community Wellness/Mary Eliza Mahoney

    • Federally Qualified Health Center (FQHC)
    • Newark, NJ
    • NPI 1972206258

    O20100113000101

    Same enrollment

National Provider Directory

National Provider Directory
Tax ID family
Dept Health and Human S14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

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

  • City of Newark

    dba Newark Dept of Health and Community Wellness Dental Mobile Unit

    • Federally Qualified Health Center (FQHC)
    • Newark, NJ
    • NPI 1104647635
    NPD tax ID
  • City of Newark

    dba Newark Dept of Health/Mary Eliza Mahoney Hlth Ctr Mobile Unit #1

    • Federally Qualified Health Center (FQHC)
    • Newark, NJ
    • NPI 1174362420
    NPD tax ID
  • City of Newark

    dba Newark Department of Health and Community Welllness

    • Federally Qualified Health Center (FQHC)
    • Newark, NJ
    • NPI 1295958908
    NPD tax ID
  • City of Newark

    dba Newark Department of Health and Community Wellness

    • Community Health Clinic/Center
    • Newark, NJ
    • NPI 1376976704
    NPD tax ID
  • City of Newark

    dba City of Newark/Dept of Health

    • Public Health or Welfare Agency
    • Newark, NJ
    • NPI 1427467034
    NPD tax ID
  • City of Newark

    dba Newark Dept of Health & Community Wellness- BC

    • Federally Qualified Health Center (FQHC)
    • Newark, NJ
    • NPI 1477914612
    NPD tax ID
  • City of Newark

    dba Newark Department of Health and Community Wellness - Mobile Van Unit

    • Federally Qualified Health Center (FQHC)
    • Newark, NJ
    • NPI 1548678303
    NPD tax ID
  • City of Newark

    dba Newark Dept of Health/Mary Eliza Mahoney Hlth Ctr Mobile Unit #3

    • Federally Qualified Health Center (FQHC)
    • Newark, NJ
    • NPI 1699514943
    NPD tax ID
  • City of Newark

    dba Newark Department of Health & Community Wellness- Women's Health Ctr

    • Federally Qualified Health Center (FQHC)
    • Newark, NJ
    • NPI 1720539620
    NPD tax ID
  • City of Newark

    dba Newark Dept of Hlth & Comm Wellness-Dental Mary Eliza Mahoney Hlth Ctr

    • Federally Qualified Health Center (FQHC)
    • Newark, NJ
    • NPI 1851757645
    NPD tax ID
  • City of Newark

    dba Newark Department of Health/Mary Eliza Mahoney Hlth Ctr Mobile Unit #2

    • Federally Qualified Health Center (FQHC)
    • Newark, NJ
    • NPI 1942059506
    NPD tax ID
  • City of Newark

    dba Newark Department of Health and Community Wellness/Mary Eliza Mahoney

    • Federally Qualified Health Center (FQHC)
    • Newark, NJ
    • NPI 1972206258
    NPD tax ID
View all 13

Practitioners & affiliated clinicians

Practitioners 24

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 24

NPI Registry JSON

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713398400000",
    "number": "1356561278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 WILLIAM ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071021304",
            "telephone_number": "973-733-7558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 WILLIAM ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071021304",
            "telephone_number": "973-733-7558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF NEWARK",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-26",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "status": "A",
        "authorized_official_last_name": "ALSBROOK",
        "authorized_official_first_name": "KETLEN",
        "authorized_official_title_or_position": "CEO/DIRECTOR",
        "authorized_official_telephone_number": "973-733-5310"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Newark Department of Health and Community Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Newark, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2024; 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.