NPIMap

Organization Active NPI

University Physician Associates of New Jersey Inc

Doing business as University Neurosurgery Associates Inc

  • Neurological Surgery Physician
  • Newark, NJ
National Provider Identifier
1780694380
Registry record updated Jul 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
Legal business name
UNIVERSITY PHYSICIAN ASSOCIATES OF NEW JERSEY INC
Doing business as
University Neurosurgery Associates Inc
Practice address
90 Bergen St
Newark, NJ 07103-2425
Phone
(973) 972-2323
NPI assigned
Aug 8, 2006
Last updated
Jul 15, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2021

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

Authorized official

Name
David Haier
Title
Ceo
Phone
(973) 972-9503

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X NU Primary

Addresses

Primary practice location

90 Bergen St
Newark, NJ 07103-2425

Mailing address

30 Bergen St
Admc 12 1205
Newark, NJ 07107-3000
Phone (973) 972-0037

Other identifiers 1

IdentifierTypeStateIssuer
5620902MedicaidNJ

Other names 1

  • University Neurosurgery Associates Inc Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041105000014 NJ Part B Supplier - Clinic/Group Practice 9830003417 Receives reassigned benefits from 17 practitioners
Practice locations: Newark, NJ

Other NPIs with the same Medicare PAC ID 15

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

View all 15

National Provider Directory

National Provider Directory

Locations

90 Bergen St
Newark, NJ 07103
Phone (973) 972-0037

Practitioners & affiliated clinicians

Practitioners 17

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 17

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626307200000",
    "number": "1780694380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 BERGEN ST",
            "address_2": "ADMC 12 1205",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071073000",
            "telephone_number": "973-972-0037",
            "fax_number": "973-972-9355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 BERGEN ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032425",
            "telephone_number": "973-972-2323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY PHYSICIAN ASSOCIATES OF NEW JERSEY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-08",
        "last_updated": "2021-07-15",
        "certification_date": "2021-07-15",
        "status": "A",
        "authorized_official_last_name": "HAIER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "973-972-9503"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5620902",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "University Neurosurgery Associates Inc",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "University Neurosurgery Associates Inc",
            "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 Jul 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.