NPIMap

Organization Active NPI

Visiting Nurse Association of Central Jersey Community Health Center I

Doing business as Red Bank Primary Care Center

  • Federally Qualified Health Center (FQHC)
  • Red Bank, NJ
National Provider Identifier
1699712166
Registry record updated Jul 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
23983 Issued in NJ
Legal business name
VISITING NURSE ASSOCIATION OF CENTRAL JERSEY COMMUNITY HEALTH CENTER I
Doing business as
Red Bank Primary Care Center
Practice address
64-66 Bridge Avenue
Red Bank, NJ 07701
Phone
(732) 219-6620
Fax
(732) 219-6625
NPI assigned
Jun 1, 2006
Last updated
Jul 29, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2026

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

Authorized official

Name
Jessica Perez
Title
Credentialing Contact
Phone
(732) 776-3915

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 23983 NJ Primary

Addresses

Primary practice location

64-66 Bridge Avenue
Red Bank, NJ 07701

Mailing address

1301 Main St
Asbury Park, NJ 07712-5359
Phone (732) 776-3915

Other practice location 1

188 E Bergen Pl Ste 302
Red Bank, NJ 07701-2162
Phone (732) 219-6620

Other names 1

  • Red Bank Primary Care Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040107000585 NJ Part B Supplier - Clinic/Group Practice 1456250679 Receives reassigned benefits from 91 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Asbury Park, NJ; Freehold, NJ; Keyport, NJ; Red Bank, NJ
O20060830000469 NJ Part A Provider - Federally Qualified Health Center (FQHC) 1456250679 Practice locations: Red Bank, NJ

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1699712166. Details of each certification follow.

Federally qualified health center certification: CCN 311865

Legal name
VISITING NURSE ASSOCIATION OF CENTRAL JERSEY COMMUNITY HEALTH CENTER I
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 20, 2006
Last certification
Oct 20, 2006
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jul 14, 1994 in NJ
Enrollment address
64-66 Bridge Ave
Red Bank, NJ 77012162

Other NPIs with the same Medicare PAC ID 4

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

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
Tax ID family
Keyport Primary Cae Center5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Kevin Gerard Rogers Individual Corporate OfficerChief Financial Officer Jan 1, 2021
Jessica Perez Individual W-2 Managing Employee Jun 16, 2016
John Thomas Zim Individual Corporate DirectorFinancial Controller Jun 19, 2023
W-2 Managing EmployeeFinancial Controller Jun 19, 2023
Debra Giordano Individual Corporate DirectorBoard Vice President Mar 1, 2006
Venkatesswara Malladi Individual Corporate DirectorBoard Member Jun 24, 2013
Beatriz Oesterheld Individual Corporate DirectorBoard Member Oct 22, 2012
Liza Dejesus Individual Corporate DirectorBoard Member May 21, 2012
Ian Brett Leber Individual Corporate OfficerChief Medical Officer Jul 1, 2023
W-2 Managing EmployeeChief Medical Officer Jul 1, 2023
Lynn Miller Individual Corporate DirectorBoard Member - Treasurer Jul 26, 2010
Heather Schulze Individual Corporate DirectorBoard Chairperson Jan 1, 2008

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 26

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 26

NPI Registry JSON

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785283200000",
    "number": "1699712166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 MAIN ST",
            "city": "ASBURY PARK",
            "state": "NJ",
            "postal_code": "077125359",
            "telephone_number": "732-776-3915",
            "fax_number": "732-774-0313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64-66 BRIDGE AVENUE",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "07701",
            "telephone_number": "732-219-6620",
            "fax_number": "732-219-6625"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "188 E Bergen Pl Ste 302",
            "address_purpose": "LOCATION",
            "city": "Red Bank",
            "state": "NJ",
            "postal_code": "077012162",
            "country_code": "US",
            "telephone_number": "732-219-6620",
            "fax_number": "732-219-6625",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "VISITING NURSE ASSOCIATION OF CENTRAL JERSEY COMMUNITY HEALTH CENTER I",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-01",
        "last_updated": "2026-07-29",
        "certification_date": "2026-07-29",
        "status": "A",
        "authorized_official_last_name": "PEREZ",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "CREDENTIALING CONTACT",
        "authorized_official_telephone_number": "732-776-3915"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NJ",
            "license": "23983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Red Bank Primary Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Red Bank, NJ

Sources for this page

Verify at the official NPI Registry.