Organization Active NPI

Chestnut Hill Convalescent Center

  • Skilled Nursing Facility
  • Passaic, NJ
National Provider Identifier
1609860287
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
CHESTNUT HILL CONVALESCENT CENTER
Practice address
360 Chestnut St
Passaic, NJ 07055-3124
Phone
(973) 777-7800
Fax
(973) 778-9013
NPI assigned
Sep 9, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Mrs. Lourdes J Ortega, RN
Title
Asst. Director of Nursing
Phone
(973) 777-7800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NJ Primary

Addresses

Primary practice location

360 Chestnut St
Passaic, NJ 07055-3124

Mailing address

360 Chestnut St
Passaic, NJ 07055-3124
Phone (973) 777-7800

Other identifiers 1

IdentifierTypeStateIssuer
4495900MedicaidNJ

National Provider Directory

National Provider Directory
Tax ID family
Chestnut Hill Residence3 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.

NPI Registry JSON

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

{
    "created_epoch": "1126224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1609860287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 CHESTNUT ST",
            "city": "PASSAIC",
            "state": "NJ",
            "postal_code": "070553124",
            "telephone_number": "973-777-7800",
            "fax_number": "973-778-9013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 CHESTNUT ST",
            "city": "PASSAIC",
            "state": "NJ",
            "postal_code": "070553124",
            "telephone_number": "973-777-7800",
            "fax_number": "973-778-9013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHESTNUT HILL CONVALESCENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-09",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "ORTEGA",
        "authorized_official_first_name": "LOURDES",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "ASST. DIRECTOR OF NURSING",
        "authorized_official_telephone_number": "973-777-7800",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4495900",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Passaic, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.