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PRI MED CARE PA
NPI 1063449023
Internal Medicine in Newark, NJ

Active since June 27, 2006CLIA 31D2298597 · Waiver
205 SUMMER AVE, NEWARK, NJ 07104(973) 484-2800 Get Directions Write a Review

NPPES record last updated: August 4, 2008. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Pri Med Care Pa NPPES

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

PRI MED CARE PA (NPI 1063449023) is a healthcare organization registered as an internal medicine in Newark, New Jersey and active in the NPI registry since June 2006. The organization holds a CLIA Waiver certificate valid through February 4, 2028 and lists Roxana Peeke, Billing, as its authorized official.

NPPES Registry Identity

NPI1063449023
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NamePRI MED CARE PA
Location Address205 SUMMER AVENewark, NJ 07104
Mailing Address205 Summer AveNewark, NJ 07104 · (973) 484-2800
Phone(973) 484-2800
Organization SubpartNo
Authorized OfficialRoxana PeekeBilling · (201) 522-3205
Enumeration DateJune 27, 2006
Last NPPES UpdateAugust 4, 2008
✔ NPI 1063449023 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 · MB06569500
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.
205 SUMMER AVE, Newark, NJ 07104
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Other Identifiers 2

Medicaid8319405NJ
Medicare PIN042388NJ

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)

Pri Med Care Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Pri Med Care PA, which bills Medicare for the services this clinician delivers.

Clinician (1)

Claudia Berdugo, D.O.
Internal Medicine
NPI 1841285780
205 SUMMER AVE
Newark, NJ 07104
(973) 484-2800
✔ PECOS✔ Accepts MedicareSame address

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 31D2298597

Pri-Med Care PA · Newark, NJ
Active · expires Feb 4, 2028
CLIA Number31D2298597
Laboratory TypePhysician Office
Certificate Effective DateFebruary 5, 2026
Certificate Expiration DateFebruary 4, 2028
Laboratory DirectorClaudia E. Berdugo
Laboratory Phone(973) 484-2800
Laboratory LocationPri-Med Care PA654 Mount Prospect Avenue Suite 202, Newark, NJ 07104
CLIA data matches this NPI record on: 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 Pri Med Care PA's NPI number?

The NPI number for Pri Med Care PA is 1063449023. It was assigned to this organization in the NPPES registry on June 27, 2006.

Where is Pri Med Care PA located?

Pri Med Care PA is located at 205 Summer Ave, Newark, NJ 07104. The listed phone number is (973) 484-2800.

What is Pri Med Care PA's specialty?

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

Is Pri Med Care PA enrolled in Medicare?

Yes. Pri Med Care PA is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Pri Med Care PA?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Internal Medicine) reassigns their Medicare billing to Pri Med Care PA. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Pri Med Care PA hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 31D2298597) is associated with this NPI, valid through February 4, 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 Pri Med Care PA was last updated on August 4, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.