Organization Active NPI

Doctors Place, Inc

  • General Practice Physician
  • Hackensack, NJ
National Provider Identifier
1659977015
Registry record updated Apr 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
DOCTORS PLACE, INC
Practice address
75 Summit Ave Ste 200
Hackensack, NJ 07601-8504
Phone
(201) 734-5853
NPI assigned
Dec 9, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2024

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

Authorized official

Name
Chantal GabrielNPI 1366584195
Title
Medical Director
Phone
(201) 734-5853

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
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X Primary
Health Service Clinic/Center 261QH0100X

Addresses

Primary practice location

75 Summit Ave Ste 200
Hackensack, NJ 07601-8504

Mailing address

226 State Street
#1018
Hackensack, NJ 07601-6451
Phone (201) 540-8647

Other names 1

  • Doctors Place Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210603000060 NJ Part B Supplier - Clinic/Group Practice 4486053915 Receives reassigned benefits from 2 practitioners
Practice locations: Hackensack, NJ

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
31D2245078Doctors Place, Inc75 Summit Ave, Ste 200, Hackensack, NJ 07601Certificate of waiverDec 7, 2027

National Provider Directory

National Provider Directory

Locations

226 State St
#1018
Hackensack, NJ 07601

75 Summit Ave
Ste 200
Hackensack, NJ 07601
Phone (201) 734-5853

75 Summit Ave
Ste 1
Hackensack, NJ 07601

75 Summit Ave
Ste 2
Hackensack, NJ 07601
Phone (201) 734-5853

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1607472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712448000000",
    "number": "1659977015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "226 STATE STREET",
            "address_2": "#1018",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076016451",
            "telephone_number": "201-540-8647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 SUMMIT AVE STE 200",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076018504",
            "telephone_number": "201-734-5853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOCTORS PLACE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-09",
        "last_updated": "2024-04-07",
        "certification_date": "2024-04-07",
        "status": "A",
        "authorized_official_last_name": "GABRIEL",
        "authorized_official_first_name": "CHANTAL",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "201-734-5853"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Doctors Place",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hackensack, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.