NPIMap

Organization Active NPI

Premise Health of New Jersey Medical, P.C

  • Clinic/Center
  • Jersey City, NJ
National Provider Identifier
1740646215
Registry record updated Aug 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
PREMISE HEALTH OF NEW JERSEY MEDICAL, P.C
Doing business as
Pershing Plaza Live Well Health Center
Practice address
95 Christopher Columbus Dr
Jersey City, NJ 07302-2978
Phone
(201) 413-2300
NPI assigned
Jan 13, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2022

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

Authorized official

Name
Jon Leizman
Title
President
Phone
(216) 479-9063

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

95 Christopher Columbus Dr
Jersey City, NJ 07302-2978

Mailing address

5500 Maryland Way
Ste 400
Brentwood, TN 37027-4948

Other names 1

  • Pershing Plaza Live Well Health Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Premise Health of New Jersey Medical PC31 organizations share this tax ID, including this one

Other organizations with this tax ID 30

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

View all 30

Locations

95 Christopher Columbus Dr
Jersey City, NJ 07302
Phone (201) 413-2300

NPI Registry JSON

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

{
    "created_epoch": "1452643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661212800000",
    "number": "1740646215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 MARYLAND WAY",
            "address_2": "STE 400",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370274948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 CHRISTOPHER COLUMBUS DR",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073022978",
            "telephone_number": "201-413-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMISE HEALTH OF NEW JERSEY MEDICAL, P.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-13",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-23",
        "status": "A",
        "authorized_official_last_name": "LEIZMAN",
        "authorized_official_first_name": "JON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "216-479-9063"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pershing Plaza Live Well Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pershing Plaza Live Well Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jersey City, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2022; 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.