NPIMap

Organization Active NPI

University Physician Associates of New Jersey Inc

  • Pediatrics Physician
  • Newark, NJ
National Provider Identifier
1679583272
Registry record updated Jul 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
UNIVERSITY PHYSICIAN ASSOCIATES OF NEW JERSEY INC
Practice address
90 Bergen St
Newark, NJ 07103-2425
Phone
(973) 972-2100
NPI assigned
Aug 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2021

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

Authorized official

Name
David Haier
Title
Ceo
Phone
(973) 972-9503

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X Primary
Child & Adolescent Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0804X

Addresses

Primary practice location

90 Bergen St
Newark, NJ 07103-2425

Mailing address

30 Bergen Street
Admc 12 1205
Newark, NJ 07107-3000
Phone (973) 972-0037

Other identifiers 1

IdentifierTypeStateIssuer
2814773MedicaidNJ

Other names 1

  • University Pediatric Associates Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050119000443 NJ Part B Supplier - Clinic/Group Practice 9830003417 Receives reassigned benefits from 62 practitioners
Practice locations: Newark, NJ

Other NPIs with the same Medicare PAC ID 15

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 15

National Provider Directory

National Provider Directory
Tax ID family
University Rehabilitati18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

Organizations that report the same tax identification number in the National Provider Directory.

View all 17

Locations

90 Bergen St
#2100
Newark, NJ 07103
Phone (973) 972-2343

90 Bergen St
Ste 4300
Newark, NJ 07103
Phone (973) 972-2100

90 Bergen St
#5100
Newark, NJ 07103
Phone (973) 972-5779

140 Bergen St
#C
Newark, NJ 07103
Phone (973) 972-2700

150 Bergen St
Rm F342
Newark, NJ 07103

90 Bergen St
#6100
Newark, NJ 07103
Phone (973) 972-2036

150 Bergen St
#162
Newark, NJ 07103

150 Bergen St
Rm 125
Newark, NJ 07103

90 Bergen St
Ste 5400
Newark, NJ 07103
Phone (973) 972-3307

150 Bergen St
#C162
Newark, NJ 07103

90 Bergen St
#4300
Newark, NJ 07103
Phone (973) 972-2100

150 Bergen St
Ste C162
Newark, NJ 07103

140 Bergen St
Ste G1600
Newark, NJ 07103
Phone (973) 972-9280

Practitioners & affiliated clinicians

Practitioners 440

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

View all 440

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626307200000",
    "number": "1679583272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 BERGEN STREET",
            "address_2": "ADMC 12 1205",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071073000",
            "telephone_number": "973-972-0037",
            "fax_number": "973-972-9355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 BERGEN ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032425",
            "telephone_number": "973-972-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY PHYSICIAN ASSOCIATES OF NEW JERSEY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-08",
        "last_updated": "2021-07-15",
        "certification_date": "2021-07-15",
        "status": "A",
        "authorized_official_last_name": "HAIER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "973-972-9503"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2814773",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "University Pediatric Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "University Pediatric Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jul 15, 2021; 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.