Organization Active NPI

Bergen-Passaic Womens Health Center LLC

  • Obstetrics & Gynecology Physician
  • Wyckoff, NJ
National Provider Identifier
1467560938
Registry record updated Mar 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
BERGEN-PASSAIC WOMENS HEALTH CENTER LLC
Practice address
258 Godwin Ave
Wyckoff, NJ 07481
Phone
(201) 891-3336
Fax
(201) 891-0627
NPI assigned
Aug 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2014

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

Authorized official

Name
Dr. Joseph Gartner, MDNPI 1861455644
Title
Owner
Phone
(201) 891-3336

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
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

258 Godwin Ave
Wyckoff, NJ 07481

Mailing address

258 Godwin Ave
Wyckoff, NJ 07481
Phone (201) 891-3336

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050413000656 NJ Part B Supplier - Clinic/Group Practice 6800833609 Receives reassigned benefits from 2 practitioners
Practice locations: Wyckoff, NJ

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
31D0722010Bergen Passaic Women'S Health Center258 Godwin Avenue, Wyckoff, NJ 07481Certificate of waiverFeb 19, 2027

National Provider Directory

National Provider Directory

Locations

258 Godwin Ave
Wyckoff, NJ 07481
Phone (201) 891-3336

Practitioners & affiliated clinicians

Practitioners 5

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": "1156550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394064000000",
    "number": "1467560938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "258 GODWIN AVE",
            "city": "WYCKOFF",
            "state": "NJ",
            "postal_code": "07481",
            "telephone_number": "201-891-3336",
            "fax_number": "201-891-0627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "258 GODWIN AVE",
            "city": "WYCKOFF",
            "state": "NJ",
            "postal_code": "07481",
            "telephone_number": "201-891-3336",
            "fax_number": "201-891-0627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERGEN-PASSAIC WOMENS HEALTH CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-26",
        "last_updated": "2014-03-06",
        "status": "A",
        "authorized_official_last_name": "GARTNER",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-891-3336",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyckoff, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.