NPIMap

Organization Active NPI

Bridgeway Behavioral Health Services

  • Community/Behavioral Health Agency
  • Elizabeth, NJ
National Provider Identifier
1639294879
Registry record updated Jun 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
204011310 Issued in NJ
Legal business name
BRIDGEWAY BEHAVIORAL HEALTH SERVICES
Practice address
615 N Broad St
Elizabeth, NJ 07208-3409
Phone
(908) 355-7886
Fax
(908) 355-6668
NPI assigned
Mar 20, 2007
Last updated
Jun 26, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2025

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

Authorized official

Name
Mr. Cory Storch
Title
Director
Phone
(908) 355-7886

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 204011310 NJ Primary

Addresses

Primary practice location

615 N Broad St
Elizabeth, NJ 07208-3409

Mailing address

615 N Broad St
Elizabeth, NJ 07208-3409
Phone (908) 355-7886

Other names 1

  • Bridgeway Rehabilitation Services Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150421002263 NJ Part B Supplier - Clinic/Group Practice 1658699715 Receives reassigned benefits from 25 practitioners
4 other NPIs on this enrollment
Practice locations: Elizabeth, NJ; Hoboken, NJ; Newton, NJ; Union, NJ

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

506 3rd St
Hoboken, NJ 07030
Phone (201) 736-7855

Practitioners & affiliated clinicians

Practitioners 31

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 31

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750896000000",
    "number": "1639294879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 N BROAD ST",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072083409",
            "telephone_number": "908-355-7886",
            "fax_number": "908-355-6668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 N BROAD ST",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072083409",
            "telephone_number": "908-355-7886",
            "fax_number": "908-355-6668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGEWAY BEHAVIORAL HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2025-06-26",
        "certification_date": "2025-06-26",
        "status": "A",
        "authorized_official_last_name": "STORCH",
        "authorized_official_first_name": "CORY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "908-355-7886",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NJ",
            "license": "204011310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bridgeway Rehabilitation Services",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Elizabeth, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2025; 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.