Central Jersey Medical Center, Inc.

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

License

24415 Issued in NJ

Legal business name

CENTRAL JERSEY MEDICAL CENTER, INC.

Practice address

246 18TH Ave
Newark, NJ 07108-2316

Phone

(973) 679-7709

NPI assigned

Feb 7, 2012

Last updated

Jan 27, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jack O'Leary

Title

Ceo

Phone

(732) 376-9333

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1447522461. Details of each certification follow.

• CCN 311907 Federally qualified health center · Active · Name & address match · Details

Federally qualified health center certification: CCN 311907

Legal name

CENTRAL JERSEY MEDICAL CENTER - CENTRAL

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Jun 13, 2014

Last certification

Jun 13, 2014

Ownership / control type

For profit – corporation

Facility address

246 18TH Avenue
Newark, NJ 07108

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

{
    "created_epoch": "1328572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674777600000",
    "number": "1447522461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1220",
            "city": "PERTH AMBOY",
            "state": "NJ",
            "postal_code": "088621220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "246 18TH AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071082316",
            "telephone_number": "973-679-7709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL JERSEY MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-07",
        "last_updated": "2023-01-27",
        "certification_date": "2023-01-27",
        "status": "A",
        "authorized_official_last_name": "O'LEARY",
        "authorized_official_first_name": "JACK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "732-376-9333"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NJ",
            "license": "24415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Federally Qualified Health Center (FQHC) in Newark, NJ
• Providers in Newark, NJ by specialty
• Federally Qualified Health Center (FQHC) in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.