NPIMap

Organization Active NPI

University Hospital

  • Clinic/Center
  • Newark, NJ
National Provider Identifier
1609178276
Registry record updated Mar 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
UNIVERSITY HOSPITAL
Practice address
140 Bergen Street
Dept. Acc Clinics, F-1776
Newark, NJ 07103-2425
Phone
(973) 972-3282
NPI assigned
Dec 2, 2010
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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 10702 NJ
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

140 Bergen Street
Dept. Acc Clinics, F-1776
Newark, NJ 07103-2425

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
O20110817000334 NJ Part B Supplier - Clinic/Group Practice 5294636874 Receives reassigned benefits from 40 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
University of Medicine and Dentistry of NJ26 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

Locations

140 Bergen St
#F1776
Newark, NJ 07103
Phone (973) 972-3282

150 Bergen St
Newark, NJ 07103
Phone (973) 972-6056

Practitioners & affiliated clinicians

Practitioners 101

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 101

NPI Registry JSON

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

{
    "created_epoch": "1291248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711584000000",
    "number": "1609178276",
    "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": "973-972-9129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 BERGEN STREET",
            "address_2": "DEPT. ACC CLINICS, F-1776",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032425",
            "telephone_number": "973-972-3282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-02",
        "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": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NJ",
            "license": "10702",
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "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.