NPIMap

Organization Active NPI

Passaic Pediatrics II PA

  • Pediatrics Physician
  • Passaic, NJ
National Provider Identifier
1942256342
Registry record updated Jun 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
25MA06599400 Issued in NJ
Legal business name
PASSAIC PEDIATRICS II PA
Practice address
913 Main Ave
Passaic, NJ 07055-8512
Phone
(973) 458-8000
Fax
(973) 458-8425
NPI assigned
May 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2008

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

Authorized official

Name
Dr. Raul Almanzar, MD
Title
Owner
Phone
(973) 458-8000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X 25MA06599400 NJ Primary

Addresses

Primary practice location

913 Main Ave
Passaic, NJ 07055-8512

Mailing address

913 Main Ave
Passaic, NJ 07055-8512
Phone (973) 458-8000

Other identifiers 5

IdentifierTypeStateIssuer
0045253MedicaidNJ
0044245MedicaidNJ
8220721MedicaidNJ
0083691MedicaidNJ
8407304MedicaidNJ

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
31D1027827Passaic Pediatrics II PA913 Main Avenue, Passaic, NJ 07055Certificate of waiverJul 14, 2026

National Provider Directory

National Provider Directory
Tax ID family
Passaic Pediatrics2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

200 Gregory Ave
#2
Passaic, NJ 07055

Practitioners & affiliated clinicians

Practitioners 12

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": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212624000000",
    "number": "1942256342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "913 MAIN AVE",
            "city": "PASSAIC",
            "state": "NJ",
            "postal_code": "070558512",
            "telephone_number": "973-458-8000",
            "fax_number": "973-458-8425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "913 MAIN AVE",
            "city": "PASSAIC",
            "state": "NJ",
            "postal_code": "070558512",
            "telephone_number": "973-458-8000",
            "fax_number": "973-458-8425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PASSAIC PEDIATRICS II PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2008-06-05",
        "status": "A",
        "authorized_official_last_name": "ALMANZAR",
        "authorized_official_first_name": "RAUL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-458-8000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA06599400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0045253",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0044245",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8220721",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0083691",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8407304",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Passaic, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.