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Organization Active NPI

Zufall Health Center,Inc

  • Community Health Clinic/Center
  • Dover, NJ
National Provider Identifier
1902990880
Registry record updated Dec 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
License
80316 Issued in NJ
Legal business name
ZUFALL HEALTH CENTER,INC
Practice address
17 South Warren Street
Dover, NJ 07801-0000
Phone
(973) 328-3344
Fax
(973) 328-6817
NPI assigned
Oct 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2023

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

Authorized official

Name
Peter Bebel
Title
Cfo
Phone
(973) 328-9100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X 80316 NJ Primary

Addresses

Primary practice location

17 South Warren Street
Dover, NJ 07801-0000

Mailing address

17 South Warren Street
Dover, NJ 07801-0000
Phone (973) 328-3344

Other identifiers 1

IdentifierTypeStateIssuer
0038750MedicaidNJ

Other names 1

  • Dover Community Clinic Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061012000595 NJ Part A Provider - Federally Qualified Health Center (FQHC) 2365448461 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Dover, NJ

Federally qualified health center certification: CCN 311866

Legal name
ZUFALL HEALTH CENTER, INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 6, 2006
Last certification
Nov 6, 2006
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jul 3, 1991 in NJ
Enrollment address
18 West Blackwell Street
Dover, NJ 78014506

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

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

18 W Blackwell St
Ste 320
Dover, NJ 07801

653 Willow Grove St
Ste 1450
Hackettstown, NJ 07840

238 Spring St
Ste A
Newton, NJ 07860
Phone 9738626650 ext. 305

415 Francis St
Somerset, NJ 08873
Phone (732) 249-6410

95 Northfield Ave
Ste 1
West Orange, NJ 07052

Ownership & related parties

All disclosed owners & managing parties 8

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 Director Nov 1, 2006
Donald Costanzo Individual Corporate Director Jun 14, 2006
William F Shuler Individual Corporate Director Jun 14, 2006
Irma M MC Kenna Individual Corporate Director Jun 14, 2006
Imogene E Anderson Individual W-2 Managing EmployeeContoller Jun 18, 2018
Peter Bebel Individual Corporate OfficerChief Financial Officer Aug 29, 2011
Amy Day Weber Individual Corporate DirectorBilling Director Jun 14, 2006
Linda L Seeley Individual Corporate Director Jun 14, 2006

Practitioners & affiliated clinicians

Practitioners 81

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

View all 81

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702598400000",
    "number": "1902990880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 SOUTH WARREN STREET",
            "city": "DOVER",
            "state": "NJ",
            "postal_code": "078010000",
            "telephone_number": "973-328-3344",
            "fax_number": "973-328-6817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 SOUTH WARREN STREET",
            "city": "DOVER",
            "state": "NJ",
            "postal_code": "078010000",
            "telephone_number": "973-328-3344",
            "fax_number": "973-328-6817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ZUFALL HEALTH CENTER,INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2023-12-15",
        "certification_date": "2023-12-15",
        "status": "A",
        "authorized_official_last_name": "BEBEL",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "973-328-9100"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "NJ",
            "license": "80316",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0038750",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dover Community Clinic",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Dover Community Clinic",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Dover, NJ

Sources for this page

Verify at the official NPI Registry.