Active NPI
University Hospital
- Primary Podiatric Medicine Podiatrist
- Newark, NJ
National Provider Identifier
1871190140
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Podiatric Medicine Podiatrist
- Legal business name
- UNIVERSITY HOSPITAL
- Practice address
- 140 Bergen St
Newark, NJ 07103-2425 - Phone
- (973) 972-4300
- NPI assigned
- Oct 8, 2020
- Last updated
- Apr 4, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. John Gary Huck
- Title
- Cfo
- Phone
- (973) 972-0882
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Podiatric Medicine Podiatrist | 213EP1101X | NU | Primary |
Addresses
Primary practice location
140 Bergen St
Newark, NJ 07103-2425
Mailing address
140 Bergen St
Newark, NJ 07103-2425
Phone (973) 972-4300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210608001055 | NJ | Part B Supplier - Hospital Department(S) | 5294636874 |
Receives reassigned benefits from 4 practitioners Practice locations: Newark, NJ |
Other NPIs with the same Medicare PAC ID 7
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
National Provider Directory
National Provider DirectoryLocations
140 Bergen St
Newark, NJ 07103
Phone (973) 972-0320
30 Bergen St
#1329
Newark, NJ 07107
Practitioners & affiliated clinicians
Practitioners 4
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.
-
- Foot & Ankle Surgery Podiatrist
- Newark, NJ
- NPI 1760837140
Single Specialty
-
- Foot & Ankle Surgery Podiatrist
- Newark, NJ
- NPI 1235243106
-
- Foot & Ankle Surgery Podiatrist
- Newark, NJ
- NPI 1841633542
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1602115200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1712188800000",
"number": "1871190140",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "140 BERGEN ST",
"city": "NEWARK",
"state": "NJ",
"postal_code": "071032425",
"telephone_number": "973-972-4300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "140 BERGEN ST",
"city": "NEWARK",
"state": "NJ",
"postal_code": "071032425",
"telephone_number": "973-972-4300"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "UNIVERSITY HOSPITAL",
"organizational_subpart": "NO",
"enumeration_date": "2020-10-08",
"last_updated": "2024-04-04",
"certification_date": "2024-04-04",
"status": "A",
"authorized_official_last_name": "HUCK",
"authorized_official_first_name": "JOHN",
"authorized_official_middle_name": "GARY",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "973-972-0882",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "213EP1101X",
"taxonomy_group": "",
"desc": "Podiatrist, Primary Podiatric Medicine",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Apr 4, 2024; 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.