NPIMap

Organization Active NPI

Careathome Medical Practice NJ

  • Internal Medicine Physician
  • Montclair, NJ
National Provider Identifier
1659974301
Registry record updated Sep 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
CAREATHOME MEDICAL PRACTICE NJ
Practice address
28 Valley Rd Ofc 229
Montclair, NJ 07042-2709
Phone
(888) 553-2823
NPI assigned
Nov 17, 2020
Last updated
Sep 6, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2022

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

Authorized official

Name
Dr. James Wood III, MDNPI 1770549735
Title
Medical Director
Phone
(704) 650-3818

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

28 Valley Rd Ofc 229
Montclair, NJ 07042-2709

Mailing address

287 Park Ave S FL 3
New York, NY 10010-4573
Phone (917) 410-7931

Other practice location 1

287 Park Ave S Fl 3
New York, NY 10010-4573
Phone (917) 410-7931

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210517000225 NJ Part B Supplier - Clinic/Group Practice 1052727120 Receives reassigned benefits from 34 practitioners
Practice locations: Montclair, NJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 34

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 34

NPI Registry JSON

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

{
    "created_epoch": "1605571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662422400000",
    "number": "1659974301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "287 PARK AVE S FL 3",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100104573",
            "telephone_number": "917-410-7931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 VALLEY RD OFC 229",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070422709",
            "telephone_number": "888-553-2823"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "287 Park Ave S Fl 3",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100104573",
            "country_code": "US",
            "telephone_number": "917-410-7931",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CAREATHOME MEDICAL PRACTICE NJ",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-17",
        "last_updated": "2022-09-06",
        "certification_date": "2022-09-06",
        "status": "A",
        "authorized_official_last_name": "WOOD",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "704-650-3818",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montclair, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2022; 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.