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

Q: 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.

Q: What is Pri Med Care PA's specialty?

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

Q: 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.

On this page

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

Open in Google Maps ↗

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

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.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JEN PHARMA INC

Pharmacy (Community/Retail Pharmacy)