Montclair Hospital LLC
Organization Active NPI General Acute Care Hospital · Montclair, NJ
NPI 1982720249 · NPPES record last updated Jun 12, 2013
Key facts
- NPI
- 1982720249
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Acute Care Hospital 282N00000X
- Legal business name
- MONTCLAIR HOSPITAL LLC
- Practice address
- 1 Bay Avenue
Montclair, NJ 07042-4837 - Phone
- (973) 429-6451
- Fax
- (973) 429-6209
- NPI assigned
- Mar 21, 2007
- Organization subpart
- No
Authorized official
- Name
- Joe Johnson
- Title
- Vice President
- Phone
- (866) 465-9222
Owners & managing parties with NPI records 22
Other NPIs on the same Medicare enrollment 1
Other NPIs with the same Medicare PAC ID 6
Corporate family (same tax ID) 6
Member of 2
Related certifications (CCN) 1
Facilities with the same owner 64
Practitioners 64
-
Kevin James Berg, MD
-
Shereen Dahab, DO
-
Preethi S George, MD
-
Roveena Noeline Goveas, M.D.
-
Michelle L Harney, L.C.S.W.
-
Edward Kosoy, M.D.
-
Young Ju Lee, MD
-
Nancy Anne Osgoodby, M.S.W.
-
Everett Schlam, MD
-
Isaac K Soliman, M.D.
-
Kaitlyn M Valente, LCSW
-
Eniola Teju Ayeni, D.O.
-
Stephanie Mora, LCSW
-
Edward Petrarca, LCSW
-
Stephen Schram, LSW
-
Jennifer Stuart, LCSW
-
Carly Thompson, LCSW
-
Aiza Akbar, M.D.
-
Valerie Allusson, MD
-
Stephanie J Kahn, LCSW
-
Merieme Klobocista, M.D.
Affiliated clinicians 462
-
Mina Kamel Abadeer, D.P.M
-
Jennifer Abitabilo, APN-C
-
Stephen M. Abo, D.O.
-
Rini Abraham, M.D.
-
Maria Adamian, CRNA
-
Mutahar Ahmed, MD
-
Aiza Akbar, M.D.
-
Morium Akthar, MD
-
Emad Alatassi, MD
-
Maryann Alessio, DO
-
Bharat Reddy Allam, D.O.
-
Naveen Reddy Allam, M.D.
-
Reddy B Allam, MD
-
Valerie Allusson, MD
-
George J Ambrosio, M.D.
-
Michelle Antonowicz, M.D.
-
Anthony Apigo, MD
-
Theresa Anne Aquino, M.D.
-
Carline F Archille, APN
-
Rosemarie Arena, MD
Medicare Care Compare: Hospital
- Listed as
- Hackensack Meridian Mountainside Medical
- Overall star rating
- ★★★★☆ 4 of 5
- Type
- Acute Care Hospitals
- Ownership
- Proprietary
- Medicare certification status
- Active
- Emergency services
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NJ
Hospital certification: CCN 310054
- Legal name
- MONTCLAIR HOSPITAL LLC
- Doing business as
- HACKENSACK MERIDIAN HEALTH, MOUNTAINSIDE MEDICAL CENTER
- Certification status
- Active
- Provider type (POS)
- Hospital – Short-term
- Participating since
- Jul 1, 1966
- Last certification
- Nov 21, 2025
- Beds
- 328
- Ownership / control type
- Private (for profit)
- Most recent change of ownership
- Jun 1, 2007 (1 total)
- Organization structure
- LLC · Proprietary
- Enrollment address
- 1 Bay Ave
Montclair, NJ 70424837 - Hospital subgroups
- Acute care
Hospital certification: CCN 31S054
- Legal name
- MONTCLAIR HOSPITAL LLC
- Doing business as
- HACKENSACK MERIDIAN HEALTH, MOUNTAINSIDE MEDICAL CENTER
- Organization structure
- LLC · Proprietary
- Enrollment address
- 1 Bay Ave
Hackensack Umc Mountainside
Montclair, NJ 70424837 - Hospital subgroups
- Psychiatric unit
All disclosed owners & managing parties 14
| Name | Role | Since | Share |
|---|---|---|---|
| LHP Montclair LLC |
5% Or Greater Indirect Ownership Interest | Jul 1, 2012 | 80% |
| Ardent Health Inc |
5% Or Greater Indirect Ownership Interest | Mar 13, 2017 | 80% |
| Martin Bonick |
Corporate Officer |
Aug 13, 2020 | |
| Richard Haun |
Corporate Officer |
Mar 13, 2017 | |
| W-2 Managing Employee |
Sep 1, 2021 | 100% | |
| Mary a Crabtree |
Corporate Officer |
Mar 13, 2017 | |
| LHP Operations Co LLC |
5% Or Greater Indirect Ownership Interest | Jul 1, 2012 | 80% |
| Montclair Health System LLC |
5% Or Greater Direct Ownership Interest | Jul 1, 2012 | 80% |
| 5% Or Greater Direct Ownership Interest | Feb 20, 2014 | ||
| Ahs Management Company Inc. |
Operational/Managerial Control | Jan 1, 2019 | 100% |
| LHP Hospital Group, Inc. |
5% Or Greater Indirect Ownership Interest | Jul 1, 2012 | 80% |
| 5% Or Greater Direct Ownership Interest | Feb 20, 2014 | ||
| Stephen C Petrovich |
Corporate Officer |
Mar 13, 2017 | |
| Corporate Officer |
Mar 13, 2017 | ||
| HMH Hospitals Corporation |
5% Or Greater Direct Ownership Interest | Feb 20, 2014 | |
| Ardent Legacy Holdings LLC |
5% Or Greater Indirect Ownership Interest | Mar 13, 2017 | 80% |
| Ahp Health Partners, Inc |
5% Or Greater Indirect Ownership Interest | Mar 13, 2017 | 80% |
| Joseph Alan Deschryver |
Corporate Director | Jan 1, 2026 | |
| W-2 Managing Employee |
Jan 1, 2026 | 100% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070419000698 | NJ | Part a Provider - Hospital | 7810092814 | Practice locations: Montclair, NJ |
| O20210525002424 | NJ | Part a Provider - Hospital | 7810092814 |
1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Montclair, NJ |
National Provider Directory
- Tax ID family
- Mountainside Hospital
Locations
799 Bloomfield Ave
Verona, NJ 07044
Phone (973) 239-1112
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Acute Care Hospital | 282N00000X | NJ | Yes |
Addresses
Primary practice location
1 Bay Avenue
Montclair, NJ 07042-4837
Mailing address
1 Bay Avenue
Administration - 3Rd Floor
Montclair, NJ 07042-4837
Phone (973) 429-6000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0139564 | Medicaid | NJ |
Other names
- HackensackUMC Mountainside
Other providers in Montclair, NJ
- Montclair Hospital LLC
- Montclair Hospital LLC
- Montclair Hospital LLC
- Montclair Hospital LLC
- Montclair Hospital LLC
- Montclair Hospital, LLC
- Montclair Memory Clinic LLC
- Montclair Pathology Associates, PA
- Montclair Pediatrics
- Montclair Performance Health and Chiropractic Inc
All providers in Montclair, NJ · General Acute Care Hospital in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 12, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.