CARE STATION MEDICAL GROUP, PA
NPI 1194045914
General Practice in West Orange, NJ

Active since June 03, 2010CLIA 31D0858025 · Waiver
456 PROSPECT AVE, WEST ORANGE, NJ 07052(973) 731-6767(973) 731-9881 Get Directions Write a Review

NPPES record last updated: March 30, 2017. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Care Station Medical Group, Pa NPPES

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

CARE STATION MEDICAL GROUP, PA (NPI 1194045914), doing business as Care Station Medical Group, is a healthcare organization registered as a general practice in West Orange, New Jersey and active in the NPI registry since June 2010. The organization holds a CLIA Waiver certificate valid through February 23, 2027 and lists Miranda J Agosto, Billing Manager, as its authorized official.

NPPES Registry Identity

NPI1194045914
Entity TypeOrganization
Primary Taxonomy208D00000X
Legal Business NameCARE STATION MEDICAL GROUP, PA
Location Address456 PROSPECT AVEWest Orange, NJ 07052-4112
Mailing AddressPo Box 352Linden, NJ 07036-0352 · (908) 925-7519 · Fax (908) 925-2842
Fax(973) 731-9881
Organization SubpartNo
Authorized OfficialMiranda J AgostoBilling Manager · (908) 925-7519
Enumeration DateJune 3, 2010
Last NPPES UpdateMarch 30, 2017
NPI 1194045914 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
Definition

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

456 PROSPECT AVE, West Orange, NJ 07052

Other Names 1

Former Legal Business NameCare Station Medical Group

Other Identifiers 2

Medicare PIN007845NJ
Medicare NSC6369960001

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

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 31D0858025

Care Station Medical Group · West Orange, NJ
Active · expires Feb 23, 2027
CLIA Number31D0858025
Laboratory TypePhysician Office
Certificate Effective DateFebruary 24, 2025
Certificate Expiration DateFebruary 23, 2027
Laboratory DirectorStanley C. Parman
Laboratory Phone(973) 731-6767
Laboratory LocationCare Station Medical Group456 Prospect Avenue, West Orange, NJ 07052
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 10

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

Family Medicine
456 PROSPECT AVE
WEST ORANGE, NJ 07052
General Practice
456 PROSPECT AVE
WEST ORANGE, NJ 07052
Physician Assistant
456 PROSPECT AVE
WEST ORANGE, NJ 07052
Family Medicine
456 PROSPECT AVE
WEST ORANGE, NJ 07052
Physician Assistant (Medical)
456 PROSPECT AVE
WEST ORANGE, NJ 07052
Family Medicine
456 PROSPECT AVE
WEST ORANGE, NJ 07052
Family Medicine
456 PROSPECT AVE
WEST ORANGE, NJ 07052
Family Medicine
456 PROSPECT AVE
WEST ORANGE, NJ 07052

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 Care Station Medical Group, PA's NPI number?

The NPI number for Care Station Medical Group, PA is 1194045914. It was assigned to this organization in the NPPES registry on June 3, 2010. The provider was formerly known as Care Station Medical Group.

Where is Care Station Medical Group, PA located?

Care Station Medical Group, PA is located at 456 Prospect Ave, West Orange, NJ 07052. The listed phone number is (973) 731-6767.

What is Care Station Medical Group, PA's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Does Care Station Medical Group, PA hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 31D0858025) is associated with this NPI, valid through February 23, 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 Care Station Medical Group, PA was last updated on March 30, 2017. NPI Profile syncs with the weekly NPPES data releases published by CMS.