NPIMap

Organization Active NPI

Newark Community Health Centers, Inc

Doing business as Ironbound Medical & Dental Center

  • Federally Qualified Health Center (FQHC)
  • Newark, NJ
National Provider Identifier
1366993586
Registry record updated Jan 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
NEWARK COMMUNITY HEALTH CENTERS, INC
Doing business as
Ironbound Medical & Dental Center
Practice address
92-96 Ferry Street
Newark, NJ 07105-1817
Phone
(973) 483-1300
NPI assigned
Oct 24, 2016
Last updated
Jan 29, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2025

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

Authorized official

Name
Dr. Pamela Clarke
Title
President &Ceo
Phone
(973) 483-1300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

92-96 Ferry Street
Newark, NJ 07105-1817

Mailing address

741 Broadway
Newark, NJ 07104-4309
Phone (973) 483-1300

Other names 1

  • Ironbound Medical & Dental Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20090729000539 NJ Part B Supplier - Clinic/Group Practice 2163334665 Receives reassigned benefits from 167 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Irvington, NJ; Orange, NJ; Newark, NJ; East Orange, NJ
O20170209001498 NJ Part A Provider - Federally Qualified Health Center (FQHC) 2163334665 Practice locations: Newark, NJ

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1366993586. Details of each certification follow.

Federally qualified health center certification: CCN 311932

Legal name
NEWARK COMMUNITY HEALTH CENTERS INC
Doing business as
IRONBOUND MEDICAL & DENTAL CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 24, 2017
Last certification
Jan 24, 2017
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
92-96 Ferry Street
Newark, NJ 71051817

Other NPIs with the same Medicare PAC ID 5

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

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Tax ID family
Newark Community Health Centersinc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

444 William St
East Orange, NJ 07017
Phone (973) 675-1900

1148 Springfield Ave
Irvington, NJ 07111
Phone (973) 399-6292

1150 Springfield Ave
Irvington, NJ 07111
Phone (973) 399-6292

741 Broadway
Newark, NJ 07104
Phone (973) 483-1300

982 Broad St
Newark, NJ 07102
Phone (973) 353-0699

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HBFIAA

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Nicole a Waryn Individual W-2 Managing EmployeeManager of Billing and Patient Fina Oct 15, 2025
Haniel Rosemond Individual W-2 Managing EmployeeBoard Member Dec 18, 2023
Arthur Nisbeth Individual Corporate OfficerBoard Member Feb 1, 2020
Corporate DirectorBoard Member Dec 5, 2014
Pamela Clarke Individual Corporate OfficerCeo Nov 1, 2010
W-2 Managing Employee Feb 1, 2017
Jacqueline Mompoint Individual Corporate OfficerBoard Member Oct 1, 2022
Corporate DirectorBoard Member Dec 5, 2014
Edward Robinson Individual Corporate OfficerTreasurer Feb 1, 2019
Corporate DirectorBoard Member Dec 5, 2014
Thomas M Ransome Individual W-2 Managing EmployeeBoard Member Dec 18, 2023
Omar M Bey Individual Corporate OfficerSecretary Jan 1, 2015
Other Feb 1, 2017
Yewande Efodili Individual Corporate DirectorDirector of Patient Financial SE Jun 17, 2025
W-2 Managing EmployeeDirector of Patient Financial Servi Jun 17, 2025
Patricia Vallejo Individual Corporate OfficerTreasurer Jul 1, 2018
Corporate DirectorBoard Member Dec 5, 2014
Cassandra Savoy Individual W-2 Managing EmployeeBoard Member May 1, 2023
Alo Gold Individual Corporate OfficerBoard Member Jun 1, 2010
Corporate DirectorBoard Member Dec 5, 2014
Michael L Moore Individual Corporate OfficerChair Jun 1, 2010
Corporate DirectorBoard Member Dec 5, 2014
Other Feb 1, 2017
Temi Boyo Individual Corporate OfficerBoard Member May 1, 2025

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 155

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 155

NPI Registry JSON

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

{
    "created_epoch": "1477267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738108800000",
    "number": "1366993586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "741 BROADWAY",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071044309",
            "telephone_number": "973-483-1300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92-96 FERRY STREET",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071051817",
            "telephone_number": "973-483-1300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEWARK COMMUNITY HEALTH CENTERS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-24",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A",
        "authorized_official_last_name": "CLARKE",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_title_or_position": "PRESIDENT &CEO",
        "authorized_official_telephone_number": "973-483-1300",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ironbound Medical & Dental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.