NPIMap

Organization Active NPI

Rutgers RWJ Eric B. Chandler Health Center

  • Federally Qualified Health Center (FQHC)
  • New Brunswick, NJ
National Provider Identifier
1538416342
Registry record updated Jul 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
RUTGERS RWJ ERIC B. CHANDLER HEALTH CENTER
Practice address
1000 Somerset St
New Brunswick, NJ 08901-3638
Phone
(732) 235-6700
Fax
(732) 235-6726
NPI assigned
Aug 10, 2012
Last updated
Jul 2, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
RUTGERS THE STATE UNIVERSITY OF NEW JERSEYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 2, 2013

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

Authorized official

Name
Sandra Adams
Title
Executive Director
Phone
(732) 235-9099

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NJ Primary

Addresses

Primary practice location

1000 Somerset St
New Brunswick, NJ 08901-3638

Mailing address

277 George St
New Brunswick, NJ 08901-1311
Phone (732) 235-6700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040116000249 NJ Part B Supplier - Clinic/Group Practice 0042111601 Receives reassigned benefits from 38 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: New Brunswick, NJ
O20130807000721 NJ Part A Provider - Federally Qualified Health Center (FQHC) 0042111601 Practice locations: New Brunswick, NJ

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1538416342. Details of each certification follow.

Federally qualified health center certification: CCN 311902

Legal name
RUTGERS RWJ ERIC B. CHANDLER HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 7, 2013
Last certification
Aug 7, 2013
Ownership / control type
For profit – corporation
Organization structure
OtherNon-profit
Incorporated
Oct 22, 1992 in NJ
Enrollment address
1000 Somerset Street
New Brunswick, NJ 89013638
Related CCNs
311811

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 2

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

Other NPIs on the same Medicare enrollment 2

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

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
31D2048246Eric B Chandler Health Center1000 Somerset Street, New Brunswick, NJ 08901Certificate of waiverMay 5, 2028

National Provider Directory

National Provider Directory
Tax ID family
Eric B Chandler HLTH Ce3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

277 George St
New Brunswick, NJ 08901
Phone (732) 235-6700

123 Church St
New Brunswick, NJ 08901
Phone (732) 235-2052

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24297/brand/1/csg/1/fhir/r4

Ownership & related parties

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Rutgers the State University of New Jersey Organization, Piscataway, NJ 5% Or Greater Direct Ownership Interest Jul 1, 2013
Rodney Reid Individual W-2 Managing Employee Nov 19, 2012
Sandra T Hill Individual Corporate DirectorExecutive Director Dec 1, 2007
Operational/Managerial ControlExecutive Director Dec 1, 2007 100%

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 2

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 36

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.

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1344556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372723200000",
    "number": "1538416342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "277 GEORGE ST",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089011311",
            "telephone_number": "732-235-6700",
            "fax_number": "732-235-6726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 SOMERSET ST",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089013638",
            "telephone_number": "732-235-6700",
            "fax_number": "732-235-6726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUTGERS RWJ ERIC B. CHANDLER HEALTH CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RUTGERS THE STATE UNIVERSITY OF NEW JERSEY",
        "enumeration_date": "2012-08-10",
        "last_updated": "2013-07-02",
        "status": "A",
        "authorized_official_last_name": "ADAMS",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "732-235-9099"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Brunswick, NJ

Sources for this page

Verify at the official NPI Registry.