Organization Active NPI

Vitamed Family Practice

  • Adolescent Medicine (Family Medicine) Physician
  • Jersey City, NJ
National Provider Identifier
1962575167
Registry record updated May 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent Medicine (Family Medicine) PhysicianTaxonomy code 207QA0000X
License
MA5867500 Issued in NJ
Legal business name
VITAMED FAMILY PRACTICE
Practice address
3000 Kennedy Blvd
Suite 308
Jersey City, NJ 07306
Phone
(201) 963-0800
Fax
(201) 656-6934
NPI assigned
Nov 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2018

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

Authorized official

Name
Tadeusz Janusz Majchrzak, MDNPI 1720061070
Title
President
Phone
(201) 963-0800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Legal MedicineGroup: 193200000X MULTI-SPECIALTY GROUP 173000000X MA5867500 NJ
Adolescent Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QA0000X MA5867500 NJ Primary

Addresses

Primary practice location

3000 Kennedy Blvd
Suite 308
Jersey City, NJ 07306

Mailing address

3000 Kennedy Blvd
Suite 308
Jersey City, NJ 07306
Phone (201) 963-0800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050803000008 NJ Part B Supplier - Clinic/Group Practice 2365470390 Receives reassigned benefits from 1 practitioner
Practice locations: Jersey City, NJ

National Provider Directory

National Provider Directory

Locations

646 Newark Ave
Jersey City, NJ 07306
Phone (201) 963-0800

610 Newark Ave
Ste 2
Jersey City, NJ 07306
Phone (201) 963-0800

Practitioners & affiliated clinicians

Practitioners 2

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": "1163635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525996800000",
    "number": "1962575167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 KENNEDY BLVD",
            "address_2": "SUITE 308",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "07306",
            "telephone_number": "201-963-0800",
            "fax_number": "201-656-6934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 KENNEDY BLVD",
            "address_2": "SUITE 308",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "07306",
            "telephone_number": "201-963-0800",
            "fax_number": "201-656-6934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITAMED FAMILY PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-16",
        "last_updated": "2018-05-11",
        "status": "A",
        "authorized_official_last_name": "MAJCHRZAK",
        "authorized_official_first_name": "TADEUSZ",
        "authorized_official_middle_name": "JANUSZ",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-963-0800",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Legal Medicine",
            "state": "NJ",
            "license": "MA5867500",
            "primary": false
        },
        {
            "code": "207QA0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Adolescent Medicine",
            "state": "NJ",
            "license": "MA5867500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jersey City, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2018; 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.