NPIMap

Organization Active NPI

Zufall Health Center, Inc

Doing business as Highlands Health Van

  • Federally Qualified Health Center (FQHC)
  • Dover, NJ
National Provider Identifier
1750618260
Registry record updated Dec 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
24344 Issued in NJ
Legal business name
ZUFALL HEALTH CENTER, INC
Doing business as
Highlands Health Van
Practice address
17 S Warren St
Dover, NJ 07801-4506
Phone
(973) 886-0815
Fax
(973) 267-7978
NPI assigned
Nov 5, 2009
Last updated
Dec 15, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2023

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

Authorized official

Name
Peter Bebel
Title
Cfo
Phone
(973) 328-9100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 24344 NJ Primary

Addresses

Primary practice location

17 S Warren St
Dover, NJ 07801-4506

Mailing address

18 W Blackwell St
Dover, NJ 07801-3841
Phone (973) 328-9100

Other identifiers 1

IdentifierTypeStateIssuer
0214019MedicaidNJ

Other names 1

  • Highlands Health Van Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120626000534 NJ Part A Provider - Federally Qualified Health Center (FQHC) 2365448461 Practice locations: Dover, NJ

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1750618260. Details of each certification follow.

Federally qualified health center certification: CCN 311899

Legal name
ZUFALL HEALTH CENTER, INC
Doing business as
HIGHLANDS HEALTH VAN
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jun 26, 2012
Last certification
Jun 26, 2012
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Dec 28, 2005 in NJ
Enrollment address
17 S Warren St
Dover, NJ 78014506

Other NPIs with the same Medicare PAC ID 9

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

National Provider Directory

National Provider Directory
Tax ID family
Zufall Health Centerinc16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

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

View all 15

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
Rina Ramirez-Alexander Individual Corporate Officer Jan 2, 2007
Frances Palm Individual Corporate Officer Jan 1, 2014
Eva Turbiner Individual Corporate OfficerPresident/Ceo Nov 1, 2006
Sam Wakim Individual Corporate Officer Sep 30, 2009
William F Shuler Individual Corporate DirectorBoard Member Nov 6, 2006
Irma M MC Kenna Individual Corporate DirectorBoard Member Nov 6, 2006
Imogene E Anderson Individual W-2 Managing EmployeeSVP Controller Oct 1, 2024
Amy Day Weber Individual Corporate DirectorBilling Director Jan 1, 2012
W-2 Managing EmployeeDirector of Billing Jan 5, 2006
Brian Whang Individual Corporate Officer Jun 1, 2009
Linda L Seeley Individual Corporate DirectorBoard Member Nov 6, 2006

Owners & managing parties with NPI records 2

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

NPI Registry JSON

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

{
    "created_epoch": "1257379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702598400000",
    "number": "1750618260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 W BLACKWELL ST",
            "city": "DOVER",
            "state": "NJ",
            "postal_code": "078013841",
            "telephone_number": "973-328-9100",
            "fax_number": "973-328-9101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 S WARREN ST",
            "city": "DOVER",
            "state": "NJ",
            "postal_code": "078014506",
            "telephone_number": "973-886-0815",
            "fax_number": "973-267-7978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ZUFALL HEALTH CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-05",
        "last_updated": "2023-12-15",
        "certification_date": "2023-12-15",
        "status": "A",
        "authorized_official_last_name": "BEBEL",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "973-328-9100"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NJ",
            "license": "24344",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0214019",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Highlands Health Van",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Highlands Health Van",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dover, NJ

Sources for this page

Verify at the official NPI Registry.