NPIMap

Newark Community Health Centers, Inc.

Organization Active NPI Federally Qualified Health Center (FQHC) · Newark, NJ

NPI 1740345693 · NPPES record last updated Jan 29, 2025

Key facts

NPI
1740345693
Entity type
Organization (NPI type 2)
Primary specialty
Federally Qualified Health Center (FQHC) 261QF0400X
License
70777 (NJ)
Legal business name
NEWARK COMMUNITY HEALTH CENTERS, INC.
Practice address
741 Broadway
Newark, NJ 07104-4309
Phone
(973) 483-1300
Fax
(973) 483-3787
NPI assigned
Dec 22, 2006
Organization subpart
No

Authorized official

Name
Pamela Clarke
Title
President & Ceo
Phone
(973) 483-1300

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Other NPIs with the same Medicare PAC ID 5

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

Corporate family (same tax ID) 6

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

Practitioners 174

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

View all 174

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in NJ

Federally qualified health center certification: CCN 311806

Legal name
NEWARK COMMUNITY HEALTH CENTERS INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 1, 1992
Last certification
Jan 1, 1992
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Enrollment address
741 Broadway
Newark, NJ 71044309

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Nicole a Waryn
Individual 		W-2 Managing Employee Oct 15, 2025
Haniel Rosemond
Individual 		W-2 Managing Employee
Board Member		 Dec 18, 2023
Arthur Nisbeth
Individual 		Corporate Director Nov 10, 2022
Pamela Clarke
Individual 		Corporate Officer
President/Ceo		 Nov 1, 2010
W-2 Managing Employee
President/Ceo		 Nov 1, 2010
Jacqueline Mompoint
Individual 		Corporate Director Nov 10, 2022
Edward Robinson
Individual 		Corporate Director Nov 10, 2022
Thomas M Ransome
Individual 		W-2 Managing Employee
Board Member		 Dec 18, 2023
Yewande Efodili
Individual 		Corporate Director
Director of Patient Financial SE		 Jun 17, 2025
W-2 Managing Employee
Director of Patient Financial SE		 Jun 17, 2025
Patricia Vallejo
Individual 		Corporate Director Nov 10, 2022
Cassandra Savoy
Individual 		W-2 Managing Employee
Board Member		 May 1, 2023
Alo Gold
Individual 		Corporate Director Nov 10, 2022
Michael L Moore
Individual 		Corporate Officer Nov 17, 2014

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20081027000263 NJ Part a Provider - Federally Qualified Health Center (FQHC) 2163334665 Practice locations: Newark, NJ
O20090729000539 NJ Part B Supplier - Clinic/Group Practice 2163334665 Receives reassigned benefits from 167 practitioners
1 other NPI on this enrollment
Practice locations: Irvington, NJ; Orange, NJ; Newark, NJ; East Orange, NJ

National Provider Directory

Tax ID family
Newark Community Health Centers (7 organizations share this tax ID)

Locations

1148 Springfield Ave
#1150
Irvington, NJ 07111

92 Ferry St
#96
Newark, NJ 07105

92 Ferry St
Newark, NJ 07105
Phone (973) 803-4510

37 N Day St
Fl 3
Orange, NJ 07050

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 70777 NJ Yes

Addresses

Primary practice location

741 Broadway
Newark, NJ 07104-4309

Mailing address

741 Broadway
Newark, NJ 07104-4309
Phone (973) 483-1300

Other identifiers

IdentifierTypeStateIssuer
0042803MedicaidNJ

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 29, 2025.

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738108800000",
    "number": "1740345693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "741 BROADWAY",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071044309",
            "telephone_number": "973-483-1300",
            "fax_number": "973-483-3787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "741 BROADWAY",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071044309",
            "telephone_number": "973-483-1300",
            "fax_number": "973-483-3787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEWARK COMMUNITY HEALTH CENTERS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-22",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A",
        "authorized_official_last_name": "CLARKE",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "973-483-1300"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NJ",
            "license": "70777",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0042803",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

All providers in Newark, NJ · Federally Qualified Health Center (FQHC) in New Jersey

Sources for this page

Verify at the official NPI Registry.