NPIMap

Organization Active NPI

Montclair State University Health Center

  • Student Health Clinic/Center
  • Montclair, NJ
National Provider Identifier
1497979132
Registry record updated Jun 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student Health Clinic/CenterTaxonomy code 261QS1000X
Legal business name
MONTCLAIR STATE UNIVERSITY HEALTH CENTER
Practice address
One Normal Ave
Montclair State University Health Center
Montclair, NJ 07043
Phone
(974) 655-4361
Fax
(973) 655-4159
NPI assigned
Apr 12, 2007
Organization subpart
Yes
Parent organization
MONTCLAIR STATE UNIVERSITYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 11, 2020

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

Authorized official

Name
Ms. Donna McMonagle
Title
Vice President for Finance and Trea
Phone
(973) 655-5105

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student Health Clinic/Center 261QS1000X Primary

Addresses

Primary practice location

One Normal Ave
Montclair State University Health Center
Montclair, NJ 07043

Mailing address

One Normal Ave
Montclair State University Health Center
Montclair, NJ 07043
Phone (974) 655-4361

Other names 2

  • Montclair State University Health Center Doing business as
  • University Health Center Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110614000186 NJ Part B Supplier - Clinic/Group Practice 0446437784 Receives reassigned benefits from 6 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bloomfield, NJ; Montclair, NJ

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Msu Center for Audiology and Speech Language Pathology4 organizations share this tax ID, including this one
Part of
Msu Center for Audiology and Speech Language Pathology

Other organizations with this tax ID 3

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

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": "1176336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591833600000",
    "number": "1497979132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE NORMAL AVE",
            "address_2": "MONTCLAIR STATE UNIVERSITY HEALTH CENTER",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "07043",
            "telephone_number": "974-655-4361",
            "fax_number": "973-655-4159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ONE NORMAL AVE",
            "address_2": "MONTCLAIR STATE UNIVERSITY HEALTH CENTER",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "07043",
            "telephone_number": "974-655-4361",
            "fax_number": "973-655-4159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTCLAIR STATE UNIVERSITY HEALTH CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MONTCLAIR STATE UNIVERSITY",
        "enumeration_date": "2007-04-12",
        "last_updated": "2020-06-11",
        "certification_date": "2020-06-11",
        "status": "A",
        "authorized_official_last_name": "MCMONAGLE",
        "authorized_official_first_name": "DONNA",
        "authorized_official_title_or_position": "VICE PRESIDENT FOR FINANCE AND TREA",
        "authorized_official_telephone_number": "973-655-5105",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Montclair State University Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Montclair State University Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "University Health Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Montclair, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 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.