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SOVEREIGN MEDICAL GROUP, LLC
NPI 1073984654
Durable Medical Equipment & Medical Supplies in Carlstadt, NJ

Active since October 08, 2015CLIA 31D2167198 · Waiver
630 BROAD ST, SUITE 2B, CARLSTADT, NJ 07072(201) 355-1700 Get Directions Write a Review

NPPES record last updated: October 8, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Sovereign Medical Group, Llc NPPES

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

SOVEREIGN MEDICAL GROUP, LLC (NPI 1073984654) is a healthcare organization registered as a durable medical equipment & medical supplies in Carlstadt, New Jersey and active in the NPI registry since October 2015. The organization holds a CLIA Waiver certificate valid through January 20, 2027 and lists John Hajjar, Owner, as its authorized official.

NPPES Registry Identity

NPI1073984654
Entity TypeOrganization
Primary Taxonomy332B00000X
Legal Business NameSOVEREIGN MEDICAL GROUP, LLC
Location Address630 BROAD ST, SUITE 2BCarlstadt, NJ 07072-1169
Mailing Address85 Harristown Rd, 2nd FloorGlen Rock, NJ 07452-3329 · (201) 855-8301
Phone(201) 355-1700
Organization SubpartNo
Authorized OfficialJohn HajjarOwner · (201) 855-8302
Enumeration DateOctober 8, 2015
✔ NPI 1073984654 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDurable Medical Equipment & Medical SuppliesSuppliers
Taxonomy Code332B00000X
Definition
A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.
630 BROAD ST, Carlstadt, NJ 07072
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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 31D2167198

Sovereign Medical Group LLC · Glen Rock, NJ
Active · expires Jan 20, 2027
CLIA Number31D2167198
Laboratory TypePhysician Office
Certificate Effective DateJanuary 21, 2025
Certificate Expiration DateJanuary 20, 2027
Laboratory DirectorJohn H. Hajjar
Laboratory Phone(201) 855-8477
Laboratory LocationSovereign Medical Group LLC85 Harristown Road Suite 102, Glen Rock, NJ 07452
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 9

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

UNIVERSITY UROLOGY ASSOCIATES, PA
Specialist
630 BROAD ST
CARLSTADT, NJ 07072
Bergen County (201) 460-8600
JEANNE BAUMANN PTA
Physical Therapy Assistant
630 BROAD ST
CARLSTADT, NJ 07072
Bergen County (201) 507-0717
SPERLING ULTRASOUND CONSULTANTS PC
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
630 BROAD ST
CARLSTADT, NJ 07072
Bergen County (760) 322-5124
DAVID BURKE P.T
Physical Therapist
630 BROAD ST
CARLSTADT, NJ 07072
Bergen County (201) 507-0717
TRANSCEND SURGERY CTR LLC
Clinic/Center (Ambulatory Surgical)
630 BROAD ST
CARLSTADT, NJ 07072
Bergen County (201) 574-7019
SURGICARE SURGICAL ASSOCIATES OF CARLSTADT, LLC
Clinic/Center (Ambulatory Surgical)
630 BROAD ST
CARLSTADT, NJ 07072
Bergen County (201) 355-1700
SOVEREIGN MEDICAL GROUP LLC
Radiology (Diagnostic Radiology)
630 BROAD ST
CARLSTADT, NJ 07072
Bergen County (201) 372-1020
SOVEREIGN HEALTH IMAGING, LLC
Clinic/Center (Radiology)
630 BROAD ST, LOWER LEVEL
CARLSTADT, NJ 07072
Bergen County (201) 372-1020

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 Sovereign Medical Group, LLC's NPI number?

The NPI number for Sovereign Medical Group, LLC is 1073984654. It was assigned to this organization in the NPPES registry on October 8, 2015.

Where is Sovereign Medical Group, LLC located?

Sovereign Medical Group, LLC is located at 630 Broad St Suite 2B, Carlstadt, NJ 07072. The listed phone number is (201) 355-1700.

What is Sovereign Medical Group, LLC's specialty?

The primary specialty registered for this NPI is Durable Medical Equipment & Medical Supplies with taxonomy code 332B00000X.

Does Sovereign Medical Group, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 31D2167198) is associated with this NPI, valid through January 20, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Sovereign Medical Group, LLC was last updated on October 8, 2015. 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.