ENNOBLE HC NJ III PC
NPI 1043192099
Family Medicine - Geriatric Medicine in Hackensack, NJ
About Ennoble Hc Nj Iii Pc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ENNOBLE HC NJ III PC (NPI 1043192099) is a healthcare organization registered as a geriatric medicine in Hackensack, New Jersey and active in the NPI registry since July 2025. The organization maintains 5 additional practice locations and lists Mark Bradshaw, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Locations 5
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Ennoble Hc Nj Iii Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
154Medicare enrollment records show 154 clinicians reassign Medicare billing to Ennoble Hc Nj III PC, which bills Medicare for the services they deliver. Of these, 9 practice at this address and 25 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 6
Nearest to this location (20)
See all 154Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Ennoble Hc Nj III PC's NPI number?
The NPI number for Ennoble Hc Nj III PC is 1043192099. It was assigned to this organization in the NPPES registry on July 22, 2025.
Where is Ennoble Hc Nj III PC located?
Ennoble Hc Nj III PC is located at 2 University Plz Ste 204, Hackensack, NJ 07601. The listed phone number is (551) 295-8223.
What is Ennoble Hc Nj III PC's specialty?
The primary specialty registered for this NPI is Family Medicine, specializing in Geriatric Medicine, with taxonomy code 207QG0300X.
Is Ennoble Hc Nj III PC enrolled in Medicare?
Yes. Ennoble Hc Nj III PC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Ennoble Hc Nj III PC?
According to the CMS Revalidation Reassignment List (October 2026 release), 154 clinicians in 6 Medicare specialties reassign their Medicare billing to Ennoble Hc Nj III PC. 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. The largest specialties are Nurse Practitioner (140), Internal Medicine (7) and Family Practice (4). Of these, 9 practice at this address and 25 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Ennoble Hc Nj III PC was last updated on August 29, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months 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.
# Ennoble Hc Nj Iii Pc · NPI 1043192099
Geriatric Medicine organization in Hackensack, New Jersey. Organization record, active in the CMS NPPES registry since July 22, 2025.
## Identity
- **NPI:** 1043192099 (Entity type: Organization)
- **Enumerated:** July 22, 2025
- **Primary specialty:** Family Medicine - Geriatric Medicine · taxonomy 207QG0300X
- **Organization subpart:** No
- **Authorized official:** Mark Bradshaw, OWNER
## Practice location
- **Address:** 2 UNIVERSITY PLZ STE 204, Hackensack, NJ 07601-6211
- **Phone:** (551) 295-8223
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 154 clinicians in 6 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (140), Internal Medicine (7), Family Practice (4); 9 practice at this address and 25 within 10 miles; [full list](https://npiprofile.com/npi/1043192099/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 29, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1043192099) · Data from the CMS NPPES public registry.