NPIMap

Organization Active NPI

Princeton Healthcare System, a New Jersey Non-Profit Corporation

Doing business as Penn Medicine Princeton Medical Center

  • General Acute Care Hospital
  • Plainsboro, NJ
National Provider Identifier
1689714255
Registry record updated Apr 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
PRINCETON HEALTHCARE SYSTEM, A NEW JERSEY NON-PROFIT CORPORATION
Doing business as
Penn Medicine Princeton Medical Center
Practice address
1 Plainsboro Rd
Plainsboro, NJ 08536-1913
Phone
(609) 853-7000
NPI assigned
Feb 6, 2007
Last updated
Apr 13, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2023

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

Authorized official

Name
Mr. Guillherme Simoes Valladares
Title
Chief Financial Officer
Phone
(609) 853-7112

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X NJ Primary

Addresses

Primary practice location

1 Plainsboro Rd
Plainsboro, NJ 08536-1913

Mailing address

1 Plainsboro Rd
Plainsboro, NJ 08536-1913
Phone (609) 853-7000

Other identifiers 2

IdentifierTypeStateIssuer
6420560OtherNJAETNA HOSPITAL
4135601MedicaidNJ

Other names 1

  • Penn Medicine Princeton Medical Center Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040901000304 NJ Part A Provider - Hospital 4587562111 Practice locations: East Windsor, NJ; Princeton, NJ; Plainsboro, NJ; North Brunswick, NJ; Moorestown, NJ; Monroe Township, NJ; Monroe, NJ; Monmouth Junction, NJ…

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1689714255. Details of each certification follow.

Hospital certification: CCN 310010

Legal name
PRINCETON HEALTHCARE SYSTEM, A NEW JERSEY NONPROFIT CORPORATION
Doing business as
PENN MEDICINE PRINCETON MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Jun 24, 2022
Beds
375
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Sep 26, 1919 in NJ
Enrollment address
1-5 Plainsboro Rd
Plainsboro, NJ 85361913
Main/Primary Hospital Location
Hospital subgroups
General, Acute care, Alcohol/drug, Long-term, Rehabilitation

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 4

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

Care Compare: Hospital

Medicare Care Compare
Listed as
University Medical Center of Princeton at PlainsboroCCN 310010 · All quality measures
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Princeton Behavioral Health10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 23

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Julia Puchtler Individual Operational/Managerial ControlSVP & Cfo Jul 1, 2020
Tara Oakman Individual Corporate DirectorBoard Member Jun 10, 2024
Calvin Butts Individual Corporate DirectorBoard Member Mar 29, 2021
William Hyncik Individual Corporate DirectorBoard Member Jun 10, 2024
Elliot a Krauss Individual Corporate DirectorBoard Member Jun 10, 2024
Myron Gellman Individual Corporate DirectorChairman Mar 29, 2021
Michael J Mardy Individual Corporate DirectorTreasurer Mar 3, 2020
Trustees of the University of Pennsylvania Organization, Philadelphia, PA Non-profit 5% Or Greater Indirect Ownership Interest Jan 1, 2018 100%
Kevin B Mahoney Individual Corporate DirectorBoard Member Jun 6, 2019
Anish a. Sheth Individual Corporate DirectorBoard Member Mar 24, 2025
Robert H Vonderheide Individual Corporate DirectorBoard Member Jul 26, 2021
Aline Holmes Individual Corporate DirectorBoard Member Jun 10, 2024
Donald Hofmann Individual Corporate DirectorEmeritus Chair Jan 19, 2012
Guilherme S Valladares Individual Corporate OfficerCfo May 1, 2014
Corporate DirectorAssistant Treasurer May 5, 2014
W-2 Managing Employee Oct 23, 2013
Philip Carchman Individual Corporate DirectorVice Chairman & Secretary Mar 3, 2020
Kim Pimley Individual Corporate DirectorEmeritus Chair Feb 22, 2010
James Demetriades Individual Corporate OfficerPresident & Ceo Mar 1, 2021
Corporate Director Mar 1, 2021
Thomas McCormick Individual Operational/Managerial ControlVP Patient Accounting Jan 1, 2018
Michael Rossi Individual W-2 Managing EmployeeDirector, Government Reimburseme Jan 1, 2018
Princeton Healthcare System Holding Inc Organization, Plainsboro, NJ Corporation, Management services company, Non-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jan 27, 1997 100%
Operational/Managerial Control Jan 27, 1997 100%
Anna C Battat Individual Corporate DirectorBoard Member Mar 23, 2026
Lori Katz Individual Corporate DirectorBoard Member Mar 29, 2021
Rosemarie Costagliola Individual Corporate DirectorAssistant Secretary Apr 1, 2013

Owners & managing parties with NPI records 14

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

View all 14

Facilities with the same owner 14

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 14

Practitioners & affiliated clinicians

Practitioners 43

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 43

Affiliated clinicians 1,120

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 1,120

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681344000000",
    "number": "1689714255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PLAINSBORO RD",
            "city": "PLAINSBORO",
            "state": "NJ",
            "postal_code": "085361913",
            "telephone_number": "609-853-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PLAINSBORO RD",
            "city": "PLAINSBORO",
            "state": "NJ",
            "postal_code": "085361913",
            "telephone_number": "609-853-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRINCETON HEALTHCARE SYSTEM, A NEW JERSEY NON-PROFIT CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-06",
        "last_updated": "2023-04-13",
        "certification_date": "2023-04-13",
        "status": "A",
        "authorized_official_last_name": "VALLADARES",
        "authorized_official_first_name": "GUILLHERME",
        "authorized_official_middle_name": "SIMOES",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "609-853-7112",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HOSPITAL",
            "identifier": "6420560",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4135601",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Penn Medicine Princeton Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Plainsboro, NJ

Sources for this page

Verify at the official NPI Registry.