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VICTORY MEDICAL CLINIC LLC
NPI 1013367465
Internal Medicine in Hackettstown, NJ

Active since June 16, 2016CLIA 31D2117496 · Waiver
433 SAND SHORE RD, HACKETTSTOWN, NJ 07840(862) 254-2299(862) 254-2300 Get Directions Write a Review

NPPES record last updated: June 16, 2016. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Victory Medical Clinic Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

VICTORY MEDICAL CLINIC LLC (NPI 1013367465) is a healthcare organization registered as an internal medicine in Hackettstown, New Jersey and active in the NPI registry since June 2016. The organization holds a CLIA Waiver certificate valid through August 16, 2028 and lists Augustine Okpala, Healthcare Professional, as its authorized official.

NPPES Registry Identity

NPI1013367465
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameVICTORY MEDICAL CLINIC LLC
Location Address433 SAND SHORE RDHackettstown, NJ 07840-5504
Mailing Address433 Sand Shore RdHackettstown, NJ 07840-5504 · (862) 254-2299 · Fax (862) 254-2300
Phone(862) 254-2299
Fax(862) 254-2300
Organization SubpartNo
Authorized OfficialAugustine OkpalaHealthcare Professional · (862) 254-2299
Enumeration DateJune 16, 2016
✔ NPI 1013367465 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in NJ · 25MA08035200
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
433 SAND SHORE RD, Hackettstown, NJ 07840
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Victory Medical Clinic Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Victory Medical Clinic LLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.

Clinicians, nearest first (2)

Nkemamaka Okpala, MD
Internal Medicine
NPI 1992062749
433 SAND SHORE RD
Hackettstown, NJ 07840
(862) 254-2299
✔ PECOS✔ Accepts MedicareSame address
Augustine Okpala, M.D
Internal Medicine
NPI 1124085766
175 HIGH ST NEWTON MEMORIAL HOSPITAL
Newton, NJ 07860
(973) 579-8321
✔ PECOS✔ Accepts Medicare14 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 31D2117496

Victory Medical Clinic · Hackettstown, NJ
Active · expires Aug 16, 2028
CLIA Number31D2117496
Laboratory TypePhysician Office
Certificate Effective DateAugust 17, 2026
Certificate Expiration DateAugust 16, 2028
Laboratory DirectorAugustine C. Okpala
Laboratory Phone(862) 254-2299
Laboratory LocationVictory Medical Clinic433 Sand Shore Road, Hackettstown, NJ 07840
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Victory Medical Clinic LLC's NPI number?

The NPI number for Victory Medical Clinic LLC is 1013367465. It was assigned to this organization in the NPPES registry on June 16, 2016.

Where is Victory Medical Clinic LLC located?

Victory Medical Clinic LLC is located at 433 Sand Shore Rd, Hackettstown, NJ 07840. The listed phone number is (862) 254-2299.

What is Victory Medical Clinic LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Victory Medical Clinic LLC enrolled in Medicare?

Yes. Victory Medical Clinic LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Victory Medical Clinic LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Internal Medicine, reassign their Medicare billing to Victory Medical Clinic LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Victory Medical Clinic LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 31D2117496) is associated with this NPI, valid through August 16, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Victory Medical Clinic LLC was last updated on June 16, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.