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PINEBROOK MEDICAL CENTER LLC,
NPI 1811205024
Clinic/Center - Primary Care in Montville, NJ

Active since September 22, 2010CLIA 31D0993076 · Waiver
170 CHANGEBRIDGE ROAD, SUITE A-3, MONTVILLE, NJ 07045(973) 808-3200(973) 808-3202 Get Directions Write a Review

NPPES record last updated: September 22, 2010. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Pinebrook Medical Center Llc, NPPES

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

PINEBROOK MEDICAL CENTER LLC, (NPI 1811205024) is a healthcare organization registered as a primary care in Montville, New Jersey and active in the NPI registry since September 2010. The organization holds a CLIA Waiver certificate valid through November 4, 2027 and lists Thomas Stack, Owner/doctor, as its authorized official.

NPPES Registry Identity

NPI1811205024
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NamePINEBROOK MEDICAL CENTER LLC,
Location Address170 CHANGEBRIDGE ROAD, SUITE A-3Montville, NJ 07045
Mailing Address170 Changebridge Rd Bldg A3Montville, NJ 07045-8802 · (973) 808-3200 · Fax (973) 808-3202
Phone(973) 808-3200
Fax(973) 808-3202
Organization SubpartNo
Authorized OfficialThomas StackOwner/doctor · (973) 808-3200
Enumeration DateSeptember 22, 2010
✔ NPI 1811205024 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
License✔ Licensed in NJ · MB58292
170 CHANGEBRIDGE ROAD, Montville, NJ 07045
Open in Google Maps ↗

Other Identifiers 2

Medicare PINST624751NJ
Medicare UPINF93378NJ

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 31D0993076

Pinebrook Medical Center · Montville, NJ
Active · expires Nov 4, 2027
CLIA Number31D0993076
Laboratory TypePhysician Office
Certificate Effective DateNovember 5, 2025
Certificate Expiration DateNovember 4, 2027
Laboratory DirectorThomas J. Stack Do
Laboratory Phone(973) 808-3200
Laboratory LocationPinebrook Medical Center170 Changebridge Road Suite A3, Montville, NJ 07045
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 2

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

MS. JOYCE LEVINE STERN LCSW CSWR
Social Worker
170 CHANGEBRIDGE ROAD, SUITE C2
MONTVILLE, NJ 07045
Morris County (973) 882-4900
MONTVILLE DENTAL STUDIO LLC
Dentist
170 CHANGEBRIDGE ROAD, SUITE A2
MONTVILLE, NJ 07045
Morris County (973) 575-6100

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 Pinebrook Medical Center LLC,'s NPI number?

The NPI number for Pinebrook Medical Center LLC, is 1811205024. It was assigned to this organization in the NPPES registry on September 22, 2010.

Where is Pinebrook Medical Center LLC, located?

Pinebrook Medical Center LLC, is located at 170 Changebridge Road Suite A-3, Montville, NJ 07045. The listed phone number is (973) 808-3200.

What is Pinebrook Medical Center LLC,'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Does Pinebrook Medical Center LLC, hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 31D0993076) is associated with this NPI, valid through November 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 Pinebrook Medical Center LLC, was last updated on September 22, 2010. 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.