Organization Active NPI

Hilal Medical Center LLC

  • Internal Medicine Physician
  • Newark, NJ
National Provider Identifier
1407181852
Registry record updated Apr 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA06156600 Issued in NJ
Legal business name
HILAL MEDICAL CENTER LLC
Practice address
482 N 12TH St
Newark, NJ 07107-1312
Phone
(973) 484-5887
Fax
(973) 484-9740
NPI assigned
Oct 2, 2009
Last updated
Apr 10, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2020

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

Authorized official

Name
Hilal AbboushiNPI 1548378029
Title
Owner
Phone
(973) 748-5700

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
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 25MA06156600 NJ Primary

Addresses

Primary practice location

482 N 12TH St
Newark, NJ 07107-1312

Mailing address

194 Broad St
Bloomfield, NJ 07003-2606
Phone (973) 484-5887

Other identifiers 1

IdentifierTypeStateIssuer
6761607MedicaidNJ

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20140408001046 NJ Part B Supplier - Clinic/Group Practice 6204068117 Receives reassigned benefits from 2 practitioners
Practice locations: Bloomfield, NJ
O20200330000464 NJ DME Supplier - Physician - Internal Medicine 6204068117 Practice locations: Bloomfield, NJ

National Provider Directory

National Provider Directory

Locations

482 N 12th St
Newark, NJ 07107
Phone (973) 484-5887

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1254441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586476800000",
    "number": "1407181852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "194 BROAD ST",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070032606",
            "telephone_number": "973-484-5887",
            "fax_number": "973-484-9740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "482 N 12TH ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071071312",
            "telephone_number": "973-484-5887",
            "fax_number": "973-484-9740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HILAL MEDICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-02",
        "last_updated": "2020-04-10",
        "certification_date": "2020-04-10",
        "status": "A",
        "authorized_official_last_name": "ABBOUSHI",
        "authorized_official_first_name": "HILAL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-748-5700"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA06156600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6761607",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 10, 2020; 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.