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CENTER FOR PREVENTATIVE MEDICINE OF NEW JERSEY
NPI 1083747299
Internal Medicine in South Orange, NJ

Active since March 14, 2007
5 STANLEY RD, SOUTH ORANGE, NJ 07079(973) 762-6077 Get Directions Write a Review

NPPES record last updated: April 16, 2013. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Center For Preventative Medicine Of New Jersey NPPES

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

CENTER FOR PREVENTATIVE MEDICINE OF NEW JERSEY (NPI 1083747299) is a healthcare organization registered as an internal medicine in South Orange, New Jersey and active in the NPI registry since March 2007. The organization lists Kevin D Holder, Owner, as its authorized official.

NPPES Registry Identity

NPI1083747299
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameCENTER FOR PREVENTATIVE MEDICINE OF NEW JERSEY
Location Address5 STANLEY RDSouth Orange, NJ 07079-2721
Mailing Address5 Stanley RdSouth Orange, NJ 07079-2721 · (973) 762-6077
Phone(973) 762-6077
Organization SubpartNo
Authorized OfficialKevin D HolderOwner · (973) 762-6077
Enumeration DateMarch 14, 2007
Last NPPES UpdateApril 16, 2013
✔ NPI 1083747299 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in NJ · 25MA04002500
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.
Also ListedFamily MedicineTaxonomy 207Q00000X · License 25MA04662500 (NJ)
5 STANLEY RD, South Orange, NJ 07079
Open in Google Maps ↗

Other Identifiers 1

Medicare PIN073942NJ

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-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)

Center For Preventative Medicine Of New Jersey 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 Center For Preventative Medicine Of New Jersey, which bills Medicare for the services this clinician delivers.

Clinician (1)

Kevin Holder, MD
Family Practice
NPI 1063543254
5 STANLEY RD
South Orange, NJ 07079
(973) 762-6077
✔ PECOS✔ Accepts Medicare0.2 mi

Source: 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 Center For Preventative Medicine Of New Jersey's NPI number?

The NPI number for Center For Preventative Medicine Of New Jersey is 1083747299. It was assigned to this organization in the NPPES registry on March 14, 2007.

Where is Center For Preventative Medicine Of New Jersey located?

Center For Preventative Medicine Of New Jersey is located at 5 Stanley Rd, South Orange, NJ 07079. The listed phone number is (973) 762-6077.

What is Center For Preventative Medicine Of New Jersey's specialty?

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

Is Center For Preventative Medicine Of New Jersey enrolled in Medicare?

Yes. Center For Preventative Medicine Of New Jersey is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Center For Preventative Medicine Of New Jersey?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Center For Preventative Medicine Of New Jersey. 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.

When was this NPI record last updated?

The NPPES record for Center For Preventative Medicine Of New Jersey was last updated on April 16, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.