HOLY NAME PRIMARY CARE AND SPECIALTY ASSOCIATES, PC
NPI 1104256130
Psychiatry & Neurology - Psychiatry in Teaneck, NJ
About Holy Name Primary Care And Specialty Associates, Pc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
HOLY NAME PRIMARY CARE AND SPECIALTY ASSOCIATES, PC (NPI 1104256130) is a healthcare organization registered as a psychiatry in Teaneck, New Jersey and active in the NPI registry since November 2013. The organization maintains a secondary practice location in Westwood and lists Vasantha Kondamudi, Cmo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 4
Secondary Practice Location 1
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)
Holy Name Primary Care And Specialty Associates, Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
49Medicare enrollment records show 49 clinicians reassign Medicare billing to Holy Name Primary Care And Specialty Associates, PC, which bills Medicare for the services they deliver. Of these, 4 practice at this address and 42 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 14
Nearest to this location (20)
See all 49Hackensack, NJ 07601
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 Holy Name Primary Care And Specialty Associates, PC's NPI number?
The NPI number for Holy Name Primary Care And Specialty Associates, PC is 1104256130. It was assigned to this organization in the NPPES registry on November 12, 2013.
Where is Holy Name Primary Care And Specialty Associates, PC located?
Holy Name Primary Care And Specialty Associates, PC is located at 718 Teaneck Rd, Teaneck, NJ 07666. The listed phone number is (201) 833-3000.
What is Holy Name Primary Care And Specialty Associates, PC's specialty?
The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.
Is Holy Name Primary Care And Specialty Associates, PC enrolled in Medicare?
Yes. Holy Name Primary Care And Specialty Associates, PC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Holy Name Primary Care And Specialty Associates, PC?
According to the CMS Revalidation Reassignment List (October 2026 release), 49 clinicians in 14 Medicare specialties reassign their Medicare billing to Holy Name Primary Care And Specialty Associates, 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 Family Practice (8), Nurse Practitioner (8) and Orthopedic Surgery (7). Of these, 4 practice at this address and 42 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 Holy Name Primary Care And Specialty Associates, PC was last updated on September 21, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 30 days 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.
# Holy Name Primary Care And Specialty Associates, Pc · NPI 1104256130
Psychiatry organization in Teaneck, New Jersey. Organization record, active in the CMS NPPES registry since November 12, 2013.
## Identity
- **NPI:** 1104256130 (Entity type: Organization)
- **Enumerated:** November 12, 2013
- **Primary specialty:** Psychiatry & Neurology - Psychiatry · taxonomy 2084P0800X
- **Organization subpart:** No
- **Authorized official:** Vasantha Kondamudi, CMO
## Practice location
- **Address:** 718 TEANECK RD, Teaneck, NJ 07666-4245
- **Phone:** (201) 833-3000 · **Fax:** (201) 227-6207
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 49 clinicians in 14 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Family Practice (8), Nurse Practitioner (8), Orthopedic Surgery (7); 4 practice at this address and 42 within 10 miles; [full list](https://npiprofile.com/npi/1104256130/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 21, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1104256130) · Data from the CMS NPPES public registry.