UROLOGY SPECIALTLY CARE PA
NPI 1205125655
Urology in Fair Lawn, NJ

Q: What is Sovereign Medical Group LLC's NPI number?

The NPI number for Sovereign Medical Group LLC is 1205125655. It was assigned to this organization in the NPPES registry on April 6, 2011. The provider is doing business as Urology Specialtly Care PA.

Q: What is Sovereign Medical Group LLC's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Active since April 06, 2011CLIA Certified · 2 labs

15-01 BROADWAY, SUITE 1 & 3, FAIR LAWN, NJ 07410(201) 791-4544(201) 794-6970 Get Directions Write a Review

NPPES record last updated: May 31, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Urology Specialtly Care Pa NPPES

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

UROLOGY SPECIALTLY CARE PA (NPI 1205125655) is a healthcare organization registered as an urology in Fair Lawn, New Jersey and active in the NPI registry since April 2011. The organization holds 2 active CLIA laboratory certificates, maintains a secondary practice location in Fair Lawn, and lists John H Hajjar, Owner, as its authorized official.

NPPES Registry Identity

NPI1205125655

Entity TypeOrganization

Primary Taxonomy208800000X

Legal Business NameSOVEREIGN MEDICAL GROUP LLC

Location Address15-01 BROADWAY, SUITE 1 & 3Fair Lawn, NJ 07410

Mailing Address85 Harristown Rd Fl 2Glen Rock, NJ 07452-3329 · (201) 855-8446 · Fax (201) 444-0350

Phone(201) 791-4544

Fax(201) 794-6970

Organization SubpartYes

Authorized OfficialJohn H HajjarOwner · (201) 791-4544

Enumeration DateApril 6, 2011

Last NPPES UpdateMay 31, 2018

✔ NPI 1205125655 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 7

★ Primary SpecialtyUrologyAllopathic & Osteopathic Physicians

Taxonomy Code208800000X

Definition

A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.

Also ListedInternal MedicineTaxonomy 207R00000X

Also ListedObstetrics & GynecologyTaxonomy 207V00000X

Also ListedPathology · Clinical PathologyTaxonomy 207ZC0006X

Also ListedRadiology · Radiation OncologyTaxonomy 2085R0001X

Also ListedRadiology · Diagnostic RadiologyTaxonomy 2085R0202X

Also ListedUrology · Pediatric UrologyTaxonomy 2088P0231X

15-01 BROADWAY, Fair Lawn, NJ 07410

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Other Names 1

Doing Business AsUrology Specialtly Care Pa

Secondary Practice Location 1

Location 115-01 Broadway, Suite 1 & 3Fair Lawn, NJ 07410-6003 · Phone (201) 791-4544 · Fax (201) 794-6970

Other Identifiers 1

Medicaid7586205NJ

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 2

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 31D2167468

Sovereign Medical Group, LLC · Fair Lawn, NJ

Active · expires Jun 9, 2027

CLIA Number31D2167468

Laboratory TypePhysician Office

Certificate Effective DateJune 10, 2025

Certificate Expiration DateJune 9, 2027

Laboratory DirectorJohn H. Hajjar

Laboratory Phone(201) 855-8477

Laboratory LocationSovereign Medical Group, LLC14-01 Broadway Suite B, Fair Lawn, NJ 07410

CLIA data matches this NPI record on: Name

This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 31D2167189

Sovereign Medical Group LLC · Fair Lawn, NJ

Active · expires Jun 3, 2027

CLIA Number31D2167189

Laboratory TypePhysician Office

Certificate Effective DateJune 4, 2025

Certificate Expiration DateJune 3, 2027

Laboratory DirectorJohn H. Hajjar

Laboratory Phone(201) 855-8477

Laboratory LocationSovereign Medical Group LLC14-01 Broadway Suite A, Fair Lawn, NJ 07410

CLIA data matches this NPI record on: Name

This certificate is issued to a laboratory to perform only waived tests.

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Other Providers at the Same Location NPPES 20

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

DR. VIKTORIA SVERDLOV DMD

Dentist

15-01 BROADWAY, SUITE 10F
FAIR LAWN, NJ 07410

Bergen County (201) 791-0130

IMEDICAL ASSOCIATES, LLC

Internal Medicine

15-01 BROADWAY, SUITE 32
FAIR LAWN, NJ 07410

Bergen County (201) 791-6434

SAILAJA DEVI VALIVETI MD

Psychiatry & Neurology (Geriatric Psychiatry)

15-01 BROADWAY
FAIR LAWN, NJ 07410

Bergen County (201) 794-7733

ROBERT GREENBLUM MD

Specialist

15-01 BROADWAY, STE 20
FAIR LAWN, NJ 07410

Bergen County (201) 794-6008

DR. THOMAS RENNY D.M.D.

Dentist (General Practice)

15-01 BROADWAY
FAIR LAWN, NJ 07410

Bergen County (201) 791-0130

SURGICARE SURGICAL ASSOCIATES OF FAIRLAWN, LLC

Clinic/Center (Ambulatory Surgical)

15-01 BROADWAY, STE 1
FAIR LAWN, NJ 07410

Bergen County (201) 703-8487

KUCHIPUDI BAPINEEDU, MD PA

Surgery

15-01 BROADWAY, STE. #22
FAIR LAWN, NJ 07410

Bergen County (201) 796-4848

MS. BEENA PATEL PT, DPT

Physical Therapist

15-01 BROADWAY, SUITE 30A
FAIR LAWN, NJ 07410

Bergen County (201) 703-7107

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 1205125655. It was assigned to this organization in the NPPES registry on April 6, 2011. The provider is doing business as Urology Specialtly Care PA.

Where is Sovereign Medical Group LLC located?

Sovereign Medical Group LLC is located at 15-01 Broadway Suite 1 & 3, Fair Lawn, NJ 07410. The listed phone number is (201) 791-4544.

What is Sovereign Medical Group LLC's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Does Sovereign Medical Group LLC hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Sovereign Medical Group LLC was last updated on May 31, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.