NPIMap

Organization Active NPI

Newark Community Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Newark, NJ
National Provider Identifier
1740345693
Registry record updated Jan 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
70777 Issued in 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
Last updated
Jan 29, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2025

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

Authorized official

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

Specialties & licenses 1

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

Addresses

Primary practice location

741 Broadway
Newark, NJ 07104-4309

Mailing address

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

Medicare participation

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

Enrollment records 2

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

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1740345693. Details of each certification follow.

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
CorporationNon-profit
Enrollment address
741 Broadway
Newark, NJ 71044309

Other NPIs with the same Medicare PAC ID 5

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

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Tax ID family
Newark Community Health Centers7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

1148 Springfield Ave
#1150
Irvington, NJ 07111

1150 Springfield Ave
Irvington, NJ 07111
Phone (973) 399-6292

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

92 Ferry St
#96
Newark, NJ 07105

37 N Day St
Fl 3
Orange, NJ 07050

Ownership & related parties

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 EmployeeBoard Member Dec 18, 2023
Arthur Nisbeth Individual Corporate Director Nov 10, 2022
Pamela Clarke Individual Corporate OfficerPresident/Ceo Nov 1, 2010
W-2 Managing EmployeePresident/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 EmployeeBoard Member Dec 18, 2023
Yewande Efodili Individual Corporate DirectorDirector of Patient Financial SE Jun 17, 2025
W-2 Managing EmployeeDirector of Patient Financial SE Jun 17, 2025
Patricia Vallejo Individual Corporate Director Nov 10, 2022
Cassandra Savoy Individual W-2 Managing EmployeeBoard Member May 1, 2023
Alo Gold Individual Corporate Director Nov 10, 2022
Michael L Moore Individual Corporate Officer Nov 17, 2014

Practitioners & affiliated clinicians

Practitioners 174

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 174

NPI Registry JSON

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

{
    "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": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.