NPIMap

Organization Active NPI

Complete Diagnostic and Medical Center LLC

  • Internal Medicine Physician
  • Hackensack, NJ
National Provider Identifier
1790469856
Registry record updated Oct 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
COMPLETE DIAGNOSTIC AND MEDICAL CENTER LLC
Practice address
126 State St
Hackensack, NJ 07601-5448
Phone
(877) 890-9906
NPI assigned
Jun 9, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2023

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

Authorized official

Name
Alexander Zaitsev, MD
Title
Managing Member
Phone
(877) 890-9906

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Phlebology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 202K00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Sleep Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RS0012X
Diagnostic Ultrasound PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085U0001X
Interventional Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0014X
PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213E00000X

Addresses

Primary practice location

126 State St
Hackensack, NJ 07601-5448

Mailing address

126 State St
Hackensack, NJ 07601-5448
Phone (877) 890-9906

National Provider Directory

National Provider Directory

Locations

126 State St
Hackensack, NJ 07601
Phone (877) 890-9906

NPI Registry JSON

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

{
    "created_epoch": "1686268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697673600000",
    "number": "1790469856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 STATE ST",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076015448",
            "telephone_number": "877-890-9906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 STATE ST",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076015448",
            "telephone_number": "877-890-9906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPLETE DIAGNOSTIC AND MEDICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-09",
        "last_updated": "2023-10-19",
        "certification_date": "2023-10-19",
        "status": "A",
        "authorized_official_last_name": "ZAITSEV",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "877-890-9906",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "202K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Phlebology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackensack, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2023; 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.