Active NPI
Central Jersey Medical Center, Inc.
- Federally Qualified Health Center (FQHC)
- Perth Amboy, NJ
National Provider Identifier
1598090292
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Federally Qualified Health Center (FQHC)
- License
- 24332
- Legal business name
- CENTRAL JERSEY MEDICAL CENTER, INC.
- Practice address
- 275 Hobart St
Mobile Unit
Perth Amboy, NJ 08861-4310 - Phone
- (732) 376-9333
- Fax
- (732) 324-5765
- NPI assigned
- Oct 14, 2009
- Last updated
- Jan 27, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jack O'Leary
- Title
- Chief Executive Officer
- Phone
- (732) 376-9333
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | 24332 | NJ | Primary |
Addresses
Primary practice location
275 Hobart St
Mobile Unit
Perth Amboy, NJ 08861-4310
Mailing address
PO Box 1220
Perth Amboy, NJ 08862-1220
Phone (732) 376-6635
Other identifiers 12
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0137616 | Medicaid | NJ | |
| 7849404 | Medicaid | NJ | |
| 0152536 | Medicaid | NJ | |
| 0193771 | Medicaid | NJ | |
| 0200841 | Medicaid | NJ | |
| 0124869 | Medicaid | NJ | |
| 0158232 | Medicaid | NJ | |
| 0183252 | Medicaid | NJ | |
| 8462500 | Medicaid | NJ | |
| 0193763 | Medicaid | NJ | |
| 0207161 | Medicaid | NJ | |
| 1342304 | Medicaid | NJ |
National Provider Directory
National Provider Directory- Tax ID family
- Central Jersey Medical Center Inc
Other organizations with this tax ID 5
Organizations that report the same tax identification number in the National Provider Directory.
-
- Federally Qualified Health Center (FQHC)
- Perth Amboy, NJ
- NPI 1710304563
-
- Federally Qualified Health Center (FQHC)
- Newark, NJ
- NPI 1982087607
-
- Federally Qualified Health Center (FQHC)
- Perth Amboy, NJ
- NPI 1891154993
-
- Federally Qualified Health Center (FQHC)
- Newark, NJ
- NPI 1225240971
-
- Federally Qualified Health Center (FQHC)
- Newark, NJ
- NPI 1356769277
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1255478400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1674777600000",
"number": "1598090292",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1220",
"city": "PERTH AMBOY",
"state": "NJ",
"postal_code": "088621220",
"telephone_number": "732-376-6635",
"fax_number": "732-324-5765"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "275 HOBART ST",
"address_2": "MOBILE UNIT",
"city": "PERTH AMBOY",
"state": "NJ",
"postal_code": "088614310",
"telephone_number": "732-376-9333",
"fax_number": "732-324-5765"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CENTRAL JERSEY MEDICAL CENTER, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2009-10-14",
"last_updated": "2023-01-27",
"certification_date": "2023-01-27",
"status": "A",
"authorized_official_last_name": "O'LEARY",
"authorized_official_first_name": "JACK",
"authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
"authorized_official_telephone_number": "732-376-9333"
},
"taxonomies": [
{
"code": "261QF0400X",
"taxonomy_group": "",
"desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
"state": "NJ",
"license": "24332",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0137616",
"state": "NJ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7849404",
"state": "NJ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0152536",
"state": "NJ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0193771",
"state": "NJ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0200841",
"state": "NJ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0124869",
"state": "NJ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0158232",
"state": "NJ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0183252",
"state": "NJ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8462500",
"state": "NJ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0193763",
"state": "NJ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0207161",
"state": "NJ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1342304",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Perth Amboy, NJ
- Catholic Charities, Diocese of Metuchen
- Catholic Charities, Diocese of Metuchen
- Catholic Charities, Diocese of Metuchen
- Central Jersey Medical Center, Inc
- Central Jersey Medical Center, Inc.
- Central Jersey Pharmacy LLC (Central Jersey Pharmacy)
- Century Medical Group
- Dorothy Yee Chan, A.P.N.
- Lily Chan, D.M.D.
- Kevin Li Chang
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.