NPIMap

Organization Active NPI

Zufall Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • West Orange, NJ
National Provider Identifier
1902217276
Registry record updated Mar 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
ZUFALL HEALTH CENTER, INC
Practice address
49 Mount Pleasant Ave
West Orange, NJ 07052-4901
Phone
(973) 325-2266
Fax
(973) 325-2773
NPI assigned
May 8, 2014
Last updated
Mar 19, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2024

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

Authorized official

Name
Elizabet Barajas
Title
Finance Administrative Assistant
Phone
(973) 344-9100

Specialties & licenses 1

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

Addresses

Primary practice location

49 Mount Pleasant Ave
West Orange, NJ 07052-4901

Mailing address

18 W Blackwell St
Dover, NJ 07801-3841
Phone (973) 344-9100

Other names 1

  • Zufall Health Center Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140722002554 NJ Part A Provider - Federally Qualified Health Center (FQHC) 2365448461 Practice locations: West Orange, NJ

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1902217276. Details of each certification follow.

Federally qualified health center certification: CCN 311912

Legal name
ZUFALL HEALTH CENTER, INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 22, 2014
Last certification
Jul 22, 2014
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jul 3, 1991 in NJ
Enrollment address
49 Mount Pleasant Ave
West Orange, NJ 70524901
Related CCNs
311866

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 9

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
31D2103819Zufall Health Center49 Mount Pleasant Avenue, West Orange, NJ 07052Certificate of waiverOct 22, 2027

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 7

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Eva Turbiner Individual Corporate OfficerPresident/Ceo Nov 1, 2006
Donald Costanzo Individual Corporate DirectorBoard Member Nov 6, 2006
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 W-2 Managing EmployeeBilling Director Jan 5, 2006
Linda L Seeley Individual Corporate DirectorBoard Member Nov 6, 2006

NPI Registry JSON

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

{
    "created_epoch": "1399507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710806400000",
    "number": "1902217276",
    "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": "973-344-9100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 MOUNT PLEASANT AVE",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070524901",
            "telephone_number": "973-325-2266",
            "fax_number": "973-325-2773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ZUFALL HEALTH CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-08",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A",
        "authorized_official_last_name": "BARAJAS",
        "authorized_official_first_name": "ELIZABET",
        "authorized_official_title_or_position": "FINANCE ADMINISTRATIVE ASSISTANT",
        "authorized_official_telephone_number": "973-344-9100"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Zufall Health Center",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in West Orange, NJ

Sources for this page

Verify at the official NPI Registry.