NPIMap

Organization Active NPI

University Hospital

  • Acute Care Nurse Practitioner
  • Newark, NJ
National Provider Identifier
1457525156
Registry record updated Mar 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
Legal business name
UNIVERSITY HOSPITAL
Practice address
150 Bergen Street
Department of Cardiology
Newark, NJ 07103-2496
Phone
(973) 972-4112
Fax
(973) 972-5444
NPI assigned
Apr 15, 2008
Last updated
Mar 18, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2024

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

Authorized official

Name
Mr. John Gary Huck
Title
Cfo
Phone
(973) 972-0882

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X NU Primary

Addresses

Primary practice location

150 Bergen Street
Department of Cardiology
Newark, NJ 07103-2496

Mailing address

30 Bergen Street
Admc 1327
Newark, NJ 07101-1709
Phone (973) 972-0882

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080527000136 NJ Part B Supplier - Hospital Department(S) 5294636874 Receives reassigned benefits from 8 practitioners
Practice locations: Newark, NJ

Other NPIs with the same Medicare PAC ID 7

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

National Provider Directory

National Provider Directory
Tax ID family
Universty of Meddent a26 organizations share this tax ID, including this one

Other organizations with this tax ID 25

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

View all 25

Locations

150 Bergen St
Ste I
Newark, NJ 07103

30 Bergen St
#1327
Newark, NJ 07107

Practitioners & affiliated clinicians

Practitioners 12

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": "1208217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710720000000",
    "number": "1457525156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 BERGEN STREET",
            "address_2": "ADMC 1327",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071011709",
            "telephone_number": "973-972-0882",
            "fax_number": "973-972-5960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 BERGEN STREET",
            "address_2": "DEPARTMENT OF CARDIOLOGY",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032496",
            "telephone_number": "973-972-4112",
            "fax_number": "973-972-5444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-15",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A",
        "authorized_official_last_name": "HUCK",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "GARY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "973-972-0882",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Mar 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.