CCMMA NJ LLC
Complete NPI Record 1124543095
Anesthesiology - Critical Care Medicine in Passaic, NJ
Active since August 11, 2017
Complete NPI Dataset
This page contains the complete raw NPPES record for Ccmma Nj Llc (NPI 1124543095), an anesthesiology organization in Passaic, NJ. All 37 fields on file are listed with their current values and official NPPES definitions, exactly as recorded in the National Plan and Provider Enumeration System. Only fields that contain data are included, so the number of fields shown varies from one NPI record to another.
Use the tools below to filter fields by category, search within the record, or jump straight to a specific field. You can download the full record as a CSV, JSON, Markdown or text file, or filter first and export only the fields you need. The Print Clean Summary button produces a printer-friendly copy of the record.
Registry File Document Utilities
- NPI: 1124543095 Field 1/37
- The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
- Entity Type Code: 2 Field 2/37
- Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
- Employer Identification Number EIN: Not available Field 3/37
- The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
- Provider Organization Name Legal Business Name: CCMMA NJ LLC Field 4/37
- The name of the organization provider. If the provider is an organization, this is the legal business name.
- Provider First Line Business Mailing Address: PO BOX 631800 Field 5/37
- The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
- Provider Business Mailing Address City Name: CINCINNATI Field 6/37
- The city name in the mailing address of the provider being identified.
- Provider Business Mailing Address State Name: OH Field 7/37
- The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
- Provider Business Mailing Address Postal Code: 452631800 Field 8/37
- The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
- Provider Business Mailing Address Country Code If outside U S : US Field 9/37
- The country code in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address country code".
- Provider Business Mailing Address Telephone Number: 8457022711 Field 10/37
- The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
- Provider Business Mailing Address Fax Number: 8882206560 Field 11/37
- The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
- Provider First Line Business Practice Location Address: 350 BOULEVARD Field 12/37
- The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
- Provider Business Practice Location Address City Name: PASSAIC Field 13/37
- The city name in the location address of the provider being identified.
- Provider Business Practice Location Address State Name: NJ Field 14/37
- The State code in the location of the provider being identified.
- Provider Business Practice Location Address Postal Code: 070552840 Field 15/37
- The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
- Provider Business Practice Location Address Country Code If outside U S : US Field 16/37
- The country code in the location address of the provider being identified.
- Provider Business Practice Location Address Telephone Number: 9733654300 Field 17/37
- The telephone number associated with the location address of the provider being identified.
- Authorized Official Last Name: LADUCA Field 20/37
- The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
- Authorized Official First Name: LAURIE Field 21/37
- The first name of the authorized official.
- Authorized Official Title or Position: MANAGER Field 22/37
- The title or position of the authorized official.
- Authorized Official Telephone Number: 8457022711 Field 23/37
- The 10-position telephone number of the authorized official.
- Healthcare Provider Taxonomy Code 1: 207RC0200X Field 24/37
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Healthcare Provider Primary Taxonomy Switch 1: N Field 25/37
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Healthcare Provider Taxonomy Code 2: 207RP1001X Field 26/37
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Healthcare Provider Primary Taxonomy Switch 2: N Field 27/37
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Healthcare Provider Taxonomy Code 3: 208600000X Field 28/37
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Healthcare Provider Primary Taxonomy Switch 3: N Field 29/37
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Healthcare Provider Taxonomy Code 4: 207LC0200X Field 30/37
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Healthcare Provider Primary Taxonomy Switch 4: Y Field 31/37
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Is Organization Subpart: N Field 32/37
- Indicates whether the provider is a subpart of a larger organization. This is a single-character code: "Y" means the entity is an organizational subpart, while "N" means it is not. Subparts typically include hospital departments, clinics, or other distinct units that fall under a parent organization.
- Healthcare Provider Taxonomy Group 1: 193200000X MULTI-SPECIALTY GROUP Field 33/37
- Specifies whether the provider is part of a single-specialty or multi-specialty business group. The possible values are: 193200000X – Multi-Specialty Group or 193400000X – Single Specialty Group. This field helps distinguish the organizational structure of a provider group.
- Healthcare Provider Taxonomy Group 2: 193200000X MULTI-SPECIALTY GROUP Field 34/37
- Specifies whether the provider is part of a single-specialty or multi-specialty business group. The possible values are: 193200000X – Multi-Specialty Group or 193400000X – Single Specialty Group. This field helps distinguish the organizational structure of a provider group.
- Healthcare Provider Taxonomy Group 3: 193200000X MULTI-SPECIALTY GROUP Field 35/37
- Specifies whether the provider is part of a single-specialty or multi-specialty business group. The possible values are: 193200000X – Multi-Specialty Group or 193400000X – Single Specialty Group. This field helps distinguish the organizational structure of a provider group.
- Healthcare Provider Taxonomy Group 4: 193200000X MULTI-SPECIALTY GROUP Field 36/37
- Specifies whether the provider is part of a single-specialty or multi-specialty business group. The possible values are: 193200000X – Multi-Specialty Group or 193400000X – Single Specialty Group. This field helps distinguish the organizational structure of a provider group.
Secondary Practice Locations 17
The first line of the secondary practice location address of the provider being identified. For providers with more than one physical location, this is a secondary practice location address. This address cannot include a Post Office box.
425 Newburgh Ct
Location 1/17West New York, NJ 07093-8340 · Phone (845) 702-2711 · Fax (888) 220-6560
100 Medical Center Way
Location 2/17Somers Point, NJ 08244-2300 · Phone (609) 653-3500
224 W 18th St Apt 8A
Location 3/17New York, NY 10011-4558 · Phone (914) 523-2189
24 Beachmont Ter
Location 4/17Caldwell, NJ 07006-4544 · Phone (845) 702-2711 · Fax (888) 220-6560
6565 Fannin St
Location 5/17Houston, TX 77030-2703 · Phone (713) 790-3311 · Fax (888) 220-6560
1 Messenger Dr
Location 6/17Colts Neck, NJ 07722-2124 · Phone (845) 702-2711 · Fax (888) 220-6560
10 Kristen Ct
Location 7/17Somerset, NJ 08873-5048 · Phone (845) 702-2711 · Fax (888) 220-6560
1315 Marlkress Rd
Location 8/17Cherry Hill, NJ 08003-2625 · Phone (845) 702-2711 · Fax (888) 220-6560
111 Central Ave
Location 9/17Newark, NJ 07102-1909 · Phone (973) 877-5000
50 Brown Cir
Location 10/17Paramus, NJ 07652-5204 · Phone (845) 702-2711 · Fax (888) 220-6560
29 Garden Pl
Location 11/17Westwood, NJ 07675-1503 · Phone (845) 702-2711 · Fax (888) 220-6560
285 Aycrigg Ave
Location 12/17Passaic, NJ 07055-3737 · Phone (845) 702-2711 · Fax (888) 220-6560
120 N Delaware St
Location 13/17Sandusky, MI 48471-1009 · Phone (810) 648-3770 · Fax (888) 220-6560
201 NW R D Mize Rd
Location 14/17Blue Springs, MO 64014-2513 · Phone (816) 228-5900 · Fax (888) 220-6560
425 W 5th St
Location 15/17East Liverpool, OH 43920-2498 · Phone (330) 385-7200 · Fax (888) 220-6560
600 S Monroe St
Location 16/17Enid, OK 73701-7211 · Phone (580) 233-2300 · Fax (888) 220-6560
129 N Washington St
Location 17/17Sumter, SC 29150-4949 · Phone (803) 774-9000 · Fax (888) 220-6560
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