NPIMap

Organization Active NPI

Family MD LLC

  • Urgent Care Clinic/Center
  • Newark, NJ
National Provider Identifier
1962176479
Registry record updated Jul 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
FAMILY MD LLC
Practice address
393 Mulberry St Ste 203
Newark, NJ 07102-3417
Phone
(201) 733-9222
Fax
(201) 777-7132
NPI assigned
Aug 7, 2021
Last updated
Jul 29, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2025

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

Authorized official

Name
Mr. HR Manager
Title
Manager
Phone
(973) 777-0000

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

393 Mulberry St Ste 203
Newark, NJ 07102-3417

Mailing address

110 Squire Hill Rd
Montclair, NJ 07043-2516
Phone (973) 370-4000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220401002357 NJ Part B Supplier - Clinic/Group Practice 9234525197 Receives reassigned benefits from 8 practitioners
1 other NPI on this enrollment
Practice locations: Newark, NJ

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

393 Mulberry St
Ste 202
Newark, NJ 07102

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1628294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753747200000",
    "number": "1962176479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 SQUIRE HILL RD",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070432516",
            "telephone_number": "973-370-4000",
            "fax_number": "973-370-4040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "393 MULBERRY ST STE 203",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071023417",
            "telephone_number": "201-733-9222",
            "fax_number": "201-777-7132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-07",
        "last_updated": "2025-07-29",
        "certification_date": "2025-07-29",
        "status": "A",
        "authorized_official_last_name": "MANAGER",
        "authorized_official_first_name": "HR",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "973-777-0000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "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 Jul 29, 2025; 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.