Providence Medical Center

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MA068918 Issued in NJ

Legal business name

PROVIDENCE MEDICAL CENTER

Practice address

25 Craig PL
North Plainfield, NJ 07060-4777

Phone

(908) 791-9993

NPI assigned

Dec 26, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Omobola A Oji, M.D.NPI 1194880583

Title

Medical Director

Phone

(908) 791-9993

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 4

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.

• Omobola A Oji, M.D.

  • Family Medicine Physician
  • North Plainfield, NJ
  • NPI 1194880583
  Medicare reassignment NPD Authorized official
• Olaitan Babarinde

  • Primary Care Nurse Practitioner
  • North Plainfield, NJ
  • NPI 1184491102
  Medicare reassignment NPD
• Gerardo Dominado Dumapit, MD

  • Internal Medicine Physician
  • South Plainfield, NJ
  • NPI 1619929627
  NPD (past)
• Thelma Dumapit Guzman, RN, MS, ANP

  • Adult Health Nurse Practitioner
  • Newark, NJ
  • NPI 1548557291
  NPD (past)

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

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1962567354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 CRAIG PL",
            "city": "NORTH PLAINFIELD",
            "state": "NJ",
            "postal_code": "070604777",
            "telephone_number": "908-791-9993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 CRAIG PL",
            "city": "NORTH PLAINFIELD",
            "state": "NJ",
            "postal_code": "070604777",
            "telephone_number": "908-791-9993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "OJI",
        "authorized_official_first_name": "OMOBOLA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "908-791-9993",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "MA068918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tharon Camaal Perry, CEO
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• Premier Chiro and Rehab LLC
• Procare Ambulette Service, LLC
• Richard R Brodman, MD.,PA.
• Shanta Ricks
• Robert B Beim MD and William J Lowe III MD PA
• Rock Avenue Dental, P.C.
• Stephanie A. Rodriguez

• Family Medicine Physician in North Plainfield, NJ
• Providers in North Plainfield, NJ by specialty
• Family Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.