NPIMap

Organization Active NPI

University Hospital

  • Certified Registered Nurse Anesthetist
  • Newark, NJ
National Provider Identifier
1609045277
Registry record updated Mar 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
UNIVERSITY HOSPITAL
Practice address
150 Bergen Street
Department of Anesthesiology
Newark, NJ 07103-2496
Phone
(973) 972-7867
Fax
(973) 972-2357
NPI assigned
Feb 27, 2008
Last updated
Mar 28, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2024

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

Authorized official

Name
Mr. John Gary Huck
Title
Cfo
Phone
(973) 972-0882

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X Primary

Addresses

Primary practice location

150 Bergen Street
Department of Anesthesiology
Newark, NJ 07103-2496

Mailing address

150 Bergen St
Newark, NJ 07103-2496
Phone (973) 972-0882

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080506000358 NJ Part B Supplier - Hospital Department(S) 5294636874 Receives reassigned benefits from 45 practitioners
Practice locations: Newark, NJ

Other NPIs with the same Medicare PAC ID 7

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

National Provider Directory

National Provider Directory
Tax ID family
Universty of Meddent a26 organizations share this tax ID, including this one

Other organizations with this tax ID 25

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

View all 25

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

Locations

150 Bergen St
#245
Newark, NJ 07103
Phone (973) 972-5672

150 Bergen St
#E245
Newark, NJ 07103
Phone (973) 972-7867

Practitioners & affiliated clinicians

Practitioners 64

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 64

NPI Registry JSON

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

{
    "created_epoch": "1204070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711584000000",
    "number": "1609045277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 BERGEN ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032496",
            "telephone_number": "973-972-0882",
            "fax_number": "973-972-5960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 BERGEN STREET",
            "address_2": "DEPARTMENT OF ANESTHESIOLOGY",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032496",
            "telephone_number": "973-972-7867",
            "fax_number": "973-972-2357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-27",
        "last_updated": "2024-03-28",
        "certification_date": "2024-03-28",
        "status": "A",
        "authorized_official_last_name": "HUCK",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "GARY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "973-972-0882",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2024; 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.