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JERSEY CITY RADIATION THERAPY LLC
NPI 1114216660
Radiology - Radiation Oncology in Jersey City, NJ

Active since April 06, 2011CLIA 31D2167250 · Waiver
631 GRAND STREET, SUITE 1-1, JERSEY CITY, NJ 07304(201) 880-7580(201) 880-7585 Get Directions Write a Review

NPPES record last updated: June 9, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Jersey City Radiation Therapy Llc NPPES

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

JERSEY CITY RADIATION THERAPY LLC (NPI 1114216660) is a healthcare organization registered as a radiation oncology in Jersey City, New Jersey and active in the NPI registry since April 2011. The organization holds a CLIA Waiver certificate valid through June 4, 2027 and lists Donald Vardaro, Administrative Director, as its authorized official.

NPPES Registry Identity

NPI1114216660
Entity TypeOrganization
Primary Taxonomy2085R0001X
Legal Business NameSOVEREIGN MEDICAL GROUP LLC
Location Address631 GRAND STREET, SUITE 1-1Jersey City, NJ 07304
Mailing Address631 Grand Street, Suite 1-1Jersey City, NJ 07304 · (201) 880-7580 · Fax (201) 880-7585
Phone(201) 880-7580
Fax(201) 880-7585
Organization SubpartYes
Authorized OfficialDonald VardaroAdministrative Director · (201) 880-7580
Enumeration DateApril 6, 2011
Last NPPES UpdateJune 9, 2011
✔ NPI 1114216660 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRadiology · Radiation OncologyAllopathic & Osteopathic Physicians
Taxonomy Code2085R0001X
Definition
A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors.
631 GRAND STREET, Jersey City, NJ 07304
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Other Names 1

Doing Business AsJersey City Radiation Therapy Llc

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 MULTIPLE 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 31D2167250

Sovereign Medical Group, LLC · Jersey City, NJ
Active · expires Jun 4, 2027
CLIA Number31D2167250
Laboratory TypePhysician Office
Certificate Effective DateJune 5, 2025
Certificate Expiration DateJune 4, 2027
Laboratory DirectorJohn H. Hajjar
Laboratory Phone(201) 855-8477
Laboratory LocationSovereign Medical Group, LLC2555 Jfk Boulevard Suite 1-A, Jersey City, NJ 07304
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

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

UROLOGY SPECIALTY CARE PA
Radiology (Radiation Oncology)
631 GRAND STREET, SUITE 1-1
JERSEY CITY, NJ 07304
Hudson County (201) 880-7580
JERSEY CITY RADIATION THERAPY LLC
Radiology (Radiation Oncology)
631 GRAND STREET, SUITE 1-1
JERSEY CITY, NJ 07304
Hudson County (201) 791-4544

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 1114216660. It was assigned to this organization in the NPPES registry on April 6, 2011. The provider is doing business as Jersey City Radiation Therapy LLC.

Where is Sovereign Medical Group LLC located?

Sovereign Medical Group LLC is located at 631 Grand Street Suite 1-1, Jersey City, NJ 07304. The listed phone number is (201) 880-7580.

What is Sovereign Medical Group LLC's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Radiation Oncology, with taxonomy code 2085R0001X.

Does Sovereign Medical Group LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 31D2167250) is associated with this NPI, valid through June 4, 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 June 9, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.