Organization Active NPI

West Paterson Family Medical Center,PA

  • Internal Medicine Physician
  • West Paterson, NJ
National Provider Identifier
1871678433
Registry record updated Dec 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
WEST PATERSON FAMILY MEDICAL CENTER,PA
Practice address
1031 McBride Ave
D109
West Paterson, NJ 07424-2559
Phone
(973) 785-4020
Fax
(973) 785-3186
NPI assigned
Oct 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2008

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

Authorized official

Name
Dr. Joseph Vitale, M.D.
Title
Secretary/Treasurer
Phone
(973) 256-7599

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

1031 McBride Ave
D109
West Paterson, NJ 07424-2559

Mailing address

1031 McBride Ave
D109
West Paterson, NJ 07424-2559
Phone (973) 785-4020

Other identifiers 1

IdentifierTypeStateIssuer
3056902MedicaidNJ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080707000023 NJ Part B Supplier - Clinic/Group Practice 4880766922 Receives reassigned benefits from 4 practitioners
Practice locations: Paterson, NJ; Woodland Park, NJ

National Provider Directory

National Provider Directory

Locations

154 Union Ave
Paterson, NJ 07502
Phone (973) 942-3618

1031 McBride Ave
Ste D109
Woodland Park, NJ 07424
Phone (973) 785-4020

999 McBride Ave
Ste B202
Woodland Park, NJ 07424
Phone (973) 256-7599

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228867200000",
    "number": "1871678433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1031 MCBRIDE AVE",
            "address_2": "D109",
            "city": "WEST PATERSON",
            "state": "NJ",
            "postal_code": "074242559",
            "telephone_number": "973-785-4020",
            "fax_number": "973-785-3186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1031 MCBRIDE AVE",
            "address_2": "D109",
            "city": "WEST PATERSON",
            "state": "NJ",
            "postal_code": "074242559",
            "telephone_number": "973-785-4020",
            "fax_number": "973-785-3186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST PATERSON FAMILY MEDICAL CENTER,PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2008-12-10",
        "status": "A",
        "authorized_official_last_name": "VITALE",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "SECRETARY/TREASURER",
        "authorized_official_telephone_number": "973-256-7599",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3056902",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Paterson, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2008; 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.