NPIMap

Organization Active NPI

Saint Michael's Medical Center, Inc.

Doing business as Saint Michael's Medical Center

  • General Acute Care Hospital
  • Newark, NJ
National Provider Identifier
1699777458
Registry record updated Oct 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
10713 Issued in NJ
Legal business name
SAINT MICHAEL'S MEDICAL CENTER, INC.
Doing business as
Saint Michael's Medical Center
Practice address
111 Central Avenue
Newark, NJ 07102-1909
Phone
(973) 877-5000
Fax
(973) 877-5367
NPI assigned
Aug 11, 2005
Last updated
Oct 24, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2012

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

Authorized official

Name
Dennis A Pettigrew
Title
Chief Financial Officer/Chief Opera
Phone
(973) 854-3588

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X 10713 NJ
Psychiatric Hospital Unit 273R00000X 10713 NJ
General Acute Care Hospital 282N00000X 10713 NJ Primary

Addresses

Primary practice location

111 Central Avenue
Newark, NJ 07102-1909

Mailing address

111 Central Avenue
Newark, NJ 07102-1909
Phone (973) 877-2853

Other identifiers 1

IdentifierTypeStateIssuer
4140508MedicaidNJ

Other names 1

  • Saint Michael's Medical Center Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1123718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351036800000",
    "number": "1699777458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 CENTRAL AVENUE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071021909",
            "telephone_number": "973-877-2853",
            "fax_number": "973-877-5367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 CENTRAL AVENUE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071021909",
            "telephone_number": "973-877-5000",
            "fax_number": "973-877-5367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAINT MICHAEL'S MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-11",
        "last_updated": "2012-10-24",
        "status": "A",
        "authorized_official_last_name": "PETTIGREW",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER/CHIEF OPERA",
        "authorized_official_telephone_number": "973-854-3588"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NJ",
            "license": "10713",
            "primary": false
        },
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "NJ",
            "license": "10713",
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NJ",
            "license": "10713",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4140508",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Saint Michael's Medical Center",
            "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 Oct 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.