Organization Active NPI

Passaic Primary Care Physicians LLC

  • Family Medicine Physician
  • Passaic, NJ
National Provider Identifier
1497955561
Registry record updated Jul 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MA069365 Issued in NJ
Legal business name
PASSAIC PRIMARY CARE PHYSICIANS LLC
Practice address
140 Passaic Ave
Passaic, NJ 07055-4797
Phone
(973) 777-8900
Fax
(973) 777-8929
NPI assigned
Jul 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2007

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

Authorized official

Name
Dr. Ishak Soliman, MDNPI 1578505509
Title
Owner/MD
Phone
(973) 714-2730

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
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X MA069365 NJ Primary

Addresses

Primary practice location

140 Passaic Ave
Passaic, NJ 07055-4797

Mailing address

140 Passaic Ave
Passaic, NJ 07055-4797
Phone (973) 777-8900

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060317000132 NJ Part B Supplier - Clinic/Group Practice 8628085586 Receives reassigned benefits from 1 practitioner
Practice locations: Passaic, NJ; Rutherford, 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
31D2078768Passaic Primary Care Physicians, LLC140 Passaic Avenue, First Floor, Passaic, NJ 07055Certificate of waiverJun 2, 2028

National Provider Directory

National Provider Directory

Locations

155 Hazel St
Clifton, NJ 07011
Phone (973) 722-3700

348 Union Ave
Rutherford, NJ 07070
Phone (201) 804-8329

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": "1184716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184716800000",
    "number": "1497955561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 PASSAIC AVE",
            "city": "PASSAIC",
            "state": "NJ",
            "postal_code": "070554797",
            "telephone_number": "973-777-8900",
            "fax_number": "973-777-8929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 PASSAIC AVE",
            "city": "PASSAIC",
            "state": "NJ",
            "postal_code": "070554797",
            "telephone_number": "973-777-8900",
            "fax_number": "973-777-8929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PASSAIC PRIMARY CARE PHYSICIANS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-18",
        "last_updated": "2007-07-18",
        "status": "A",
        "authorized_official_last_name": "SOLIMAN",
        "authorized_official_first_name": "ISHAK",
        "authorized_official_title_or_position": "OWNER/MD",
        "authorized_official_telephone_number": "973-714-2730",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "MA069365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Passaic, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2007; 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.