PRIME HEALTHCARE SERVICES - ST MICHAELS LLC (NPI# 1568825545) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568825545 |
| Entity Type | Organization |
| Organization Name | PRIME HEALTHCARE SERVICES - ST MICHAELS LLC |
| Other Organization Name | SAINT MICHAEL'S MEDICAL CENTER |
| Practice Address |
111 Central Ave Newark NJ 07102-1909 |
| Practice Telephone | 9738772853 |
| Practice Fax Number | 9738775367 |
| Mailing Telephone | 9738772853 |
| Mailing Fax Number | 9738775367 |
| Enumeration Date | 2016-03-29 |
| Last Update Date | 2016-03-29 |
| Authorized Official Name | CHRISTOPHER DOAN (CHIEF COMPLIANCE COUNSEL) |
| Authorized Official Telephone | 9092354307 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
10713 | NJ | Ambulatory Health Care Facilities |
| N | 273R00000X | Psychiatric Unit | 10713 | NJ | Hospital Units |
| Y | 282N00000X | General Acute Care Hospital | 10713 | NJ | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | 4140508 | 05 |
| Other Name | Type Code |
|---|---|
| Saint Michael's Medical Center | Other Name - Individual/Organization |
| Street Address |
111 CENTRAL AVE |
| City | NEWARK |
| State | NJ |
| Zip Code | 07102-1909 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780687806 | Sandhya R Makkapati | Specialist | 111 Central Ave, Newark, NJ 07102-1909 | 2005-05-23 |
| 1740892496 | Stella Monday Wangai | Nurse Practitioner | 111 Central Ave, Newark, NJ 07102-1909 | 2020-08-22 |
| 1144832932 | Sonya Wali | Student in an Organized Health Care Education/Training Program | 111 Central Ave, Newark, NJ 07102-1909 | 2020-08-21 |
| 1023620358 | Chrystina Mildred Kiwan | Student in an Organized Health Care Education/Training Program | 111 Central Ave, Newark, NJ 07102-1909 | 2020-08-18 |
| 1518579838 | Alicia Kovach | Student in an Organized Health Care Education/Training Program | 111 Central Ave, Newark, NJ 07102-1909 | 2020-08-18 |
| 1861003659 | Riyashat Kazmi | Student in an Organized Health Care Education/Training Program | 111 Central Ave, Newark, NJ 07102-1909 | 2020-08-13 |
| 1114537610 | Kalee Larsen | Student in an Organized Health Care Education/Training Program | 111 Central Ave, Newark, NJ 07102-1909 | 2020-08-09 |
| 1215547567 | Nirav Patel | Student in an Organized Health Care Education/Training Program | 111 Central Ave, Newark, NJ 07102-1909 | 2020-08-02 |
| 1720697238 | Sneha Bijoy | Student in an Organized Health Care Education/Training Program | 111 Central Ave, Newark, NJ 07102-1909 | 2020-07-30 |
| 1407465891 | Ruhma Ali | Student in an Organized Health Care Education/Training Program | 111 Central Ave, Newark, NJ 07102-1909 | 2020-07-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487253779 | Integrity, Inc | Clinic/Center | 1091-1093 Broad Street, Newark, NJ 07102 | 2020-10-19 |
| 1881292720 | Oluwaseun Ademulegun | Pharmacist | 1084 Broad Street, Newark, Newark, NJ 07102 | 2020-10-13 |
| 1679042295 | Henry Paul Grayner | Specialist/Technologist | 100 Lock St, Newark, NJ 07102 | 2018-11-14 |
| 1548736838 | Integrity, Inc | Substance Abuse Rehabilitation Facility | 101 Lincoln Park, 2nd Floor, Newark, NJ 07102 | 2018-10-15 |
| 1962981407 | Crystal Kay-baune Mccown | Social Worker | 130 Orange St, Newark, NJ 07102 | 2018-08-07 |
| 1053808865 | Nubi Consultants Corp. Dba Aplus Home Care | Physical Therapist | 11 Franklin Street, 11 Franklin Street, Newark, NJ 07102 | 2018-04-17 |
| 1396249264 | Integrity, Inc | Substance Abuse Rehabilitation Facility | 49 Lincoln Park, Newark, NJ 07102 | 2018-03-23 |
| 1568960896 | Saint James Health Inc | Clinic/Center | 36 Halsey Street, Newark, NJ 07102 | 2018-02-01 |
| 1992216527 | Metropolitan Center for Human Services | Psychologist | 520 Dr. Martin Luther King, Jr. Boulevard, Newark, NJ 07102 | 2017-10-23 |
| 1467974949 | Ahmad Mohammad Tawfiq Damati | Student in an Organized Health Care Education/Training Program | 123 University Ave, Newark, Nj 07102, Newark, NJ 07102 | 2017-07-17 |
| Find all providers in zip 07102 | ||||
| Taxonomy Code | 282N00000X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538605795 | Christiana Care Health System | General Acute Care Hospital | Christiana Care Heart & Vascular Health, 4755 Ogletown-stanton Road, Newark, DE 19718-0001 | 2017-01-12 |
| 1295026334 | University of Medicine and Dentistry of New Jersey | General Acute Care Hospital | 62 Marrow St, Newark, NJ 07103-3131 | 2011-04-24 |
| 1336456201 | Christiana Care Health Services | General Acute Care Hospital | 4755 Stanton Ogletown Rd, Newark, DE 19718-0001 | 2010-09-13 |
| 1912173667 | Christiana Care Health Services | General Acute Care Hospital | 4745 Ogletown Stanton Rd Ste 128, Newark, DE 19713-2082 | 2008-05-02 |
| 1487863668 | Center for Childhood and Neonatal Surgery | General Acute Care Hospital | 90 Bergen St. Suite 7100, Newark, NJ 07103 | 2007-05-22 |
| 1306053483 | University Hospital | General Acute Care Hospital | 150 Bergen St # D106, Newark, NJ 07103-2496 | 2007-05-17 |
| 1578694626 | Christianacarehealthservices | General Acute Care Hospital | 30 Garvey Ln, Newark, DE 19702-6302 | 2007-03-08 |
| 1487790663 | University Psychiatric Associates | General Acute Care Hospital | Upa, 183 South Orange Ave, Newark, NJ 07103 | 2007-01-29 |
| 1083192298 | Christiana Care Health System | General Acute Care Hospital | 4755 Ogletown Stanton Rd Ste 5a43, Newark, DE 19718-2200 | 2018-07-31 |
| 1487181228 | Newark Beth Israel Medical Center | General Acute Care Hospital | 201 Lyons Ave, Department of Emergency Medicine, Newark, NJ 07112-2027 | 2017-05-11 |
| Find all providers in NEWARK | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.