NPIMap

Organization Active NPI

Hudson Premier Medical PC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Secaucus, NJ
National Provider Identifier
1548809221
Registry record updated Feb 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
Legal business name
HUDSON PREMIER MEDICAL PC
Practice address
55 Meadowlands Pkwy
Secaucus, NJ 07094-2977
Phone
(201) 325-6744
NPI assigned
Dec 30, 2019
Last updated
Feb 2, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2023

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

Authorized official

Name
Nizar Kifaieh, MDNPI 1235122524
Title
President
Phone
(201) 392-3100

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 5

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X NU Primary
Internal Medicine Physician 207R00000X NU
Obstetrics & Gynecology Physician 207V00000X NU
Vascular & Interventional Radiology Physician 2085R0204X NU
Hospitalist Physician 208M00000X NU

Addresses

Primary practice location

55 Meadowlands Pkwy
Secaucus, NJ 07094-2977

Mailing address

PO Box 825403
Philadelphia, PA 19182-5403

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200604002360 NJ Part B Supplier - Clinic/Group Practice 4688095367 Receives reassigned benefits from 66 practitioners
Practice locations: Secaucus, NJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 67

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 67

NPI Registry JSON

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

{
    "created_epoch": "1577664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675296000000",
    "number": "1548809221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 825403",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191825403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 MEADOWLANDS PKWY",
            "city": "SECAUCUS",
            "state": "NJ",
            "postal_code": "070942977",
            "telephone_number": "201-325-6744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUDSON PREMIER MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-30",
        "last_updated": "2023-02-02",
        "certification_date": "2023-01-27",
        "status": "A",
        "authorized_official_last_name": "KIFAIEH",
        "authorized_official_first_name": "NIZAR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-392-3100",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Secaucus, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2023; 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.