NPIMap

Organization Active NPI

Columbus Hospital Ltach LLC

  • Psychiatric Hospital Unit
  • Newark, NJ
National Provider Identifier
1376294207
Registry record updated May 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
Legal business name
COLUMBUS HOSPITAL LTACH LLC
Practice address
495 N 13TH St
Newark, NJ 07107-1317
Phone
(973) 387-7901
Fax
(973) 587-7830
NPI assigned
Jan 12, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2022

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

Authorized official

Name
Linda A La Forgia
Title
Vice President
Phone
(973) 387-7901

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X Primary

Addresses

Primary practice location

495 N 13TH St
Newark, NJ 07107-1317

Mailing address

495 N 13TH St
Newark, NJ 07107-1317
Phone (973) 387-7901

Other names 1

  • Silver Lake Hospital LTACH Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220210002577 NJ Part A Provider - Hospital 4587797857 Practice locations: Newark, NJ

Hospital certification: CCN 31SA24

Legal name
COLUMBUS HOSPITAL LTACH, LLC
Doing business as
SILVER LAKE HOSPITAL LTACH
Organization structure
LLCProprietary
Incorporated
Mar 15, 2010 in NJ
Enrollment address
495 N 13TH St
Newark, NJ 71071317
Hospital Psychiatric Unit
Hospital subgroups
Psychiatric unit

Other NPIs with the same Medicare PAC ID 1

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

National Provider Directory

National Provider Directory
Tax ID family
Columbus Hospital Ltach LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Richard Z Lipsky Individual 5% Or Greater Direct Ownership Interest Apr 1, 2011
Linda Laforgia Individual Corporate Director Nov 1, 2014
W-2 Managing Employee Nov 1, 2014
Karli Anne Kohut Individual Corporate DirectorCeo Apr 26, 2021 50%
W-2 Managing EmployeeCeo Jan 1, 2015 50%
Operational/Managerial ControlCeo Apr 26, 2021 50%

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Silver Lake Hospital LtachNewark, NJ, CCN 312024 Hospital Operational/Managerial Control Oct 1, 2023

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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": "1641945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652400000000",
    "number": "1376294207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "495 N 13TH ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071071317",
            "telephone_number": "973-387-7901",
            "fax_number": "973-587-7830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 N 13TH ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071071317",
            "telephone_number": "973-387-7901",
            "fax_number": "973-587-7830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLUMBUS HOSPITAL LTACH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-12",
        "last_updated": "2022-05-13",
        "certification_date": "2022-05-13",
        "status": "A",
        "authorized_official_last_name": "LA FORGIA",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "973-387-7901"
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Silver Lake Hospital LTACH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.