PRIMARY CARE MEDICAL PRACTICE, LLC
NPI 1912113002
Specialist in Woodland Park, NJ
NPI Status: Active since May 15, 2007
Contact Information
1031 MCBRIDE AVE
SUITE D 205
WOODLAND PARK, NJ
ZIP 07424
Phone: (973) 237-9055
Fax: (973) 237-9053
- Organization
- Specialist
- Accepts Insurance
- CLIA Number: 31D1007826
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 01-01-2027
About PRIMARY CARE MEDICAL PRACTICE, LLC
This page provides the complete NPI Profile along with additional information for Primary Care Medical Practice, Llc, a provider established in Woodland Park, New Jersey operating as a Specialist. The healthcare provider is registered in the NPI registry with number 1912113002 assigned on May 2007. The practitioner's primary taxonomy code is 174400000X with license number MA061762 (NJ). The provider is registered as an organization and their NPI record was last updated 13 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Dr. Samuel Issam Mallouhi M.d (President)
- NPI
- 1912113002
- Provider Name
- PRIMARY CARE MEDICAL PRACTICE, LLC
- Entity Type
- Organization
- Location Address
- 1031 MCBRIDE AVE SUITE D 205 WOODLAND PARK, NJ 07424
- Location Phone
- (973) 237-9055
- Location Fax
- (973) 237-9053
- Mailing Address
- 1031 MCBRIDE AVE SUITE D 205 WOODLAND PARK, NJ 07424
- Mailing Phone
- (973) 237-9055
- Mailing Fax
- (973) 237-9053
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 05-15-2007
- Last Update Date
- 07-01-2013
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Specialist
- Taxonomy Code
- 174400000X
- Type
- Other Service Providers
- License No.
- MA061762
- License State
- NJ
- Taxonomy Description
- An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Everyday Gold - HMO
- Everyday Gold + Vision + Adult Dental - HMO
- Focused Silver - HMO
- Focused Silver + Vision + Adult Dental - HMO
- Standard Expanded Bronze - HMO
- Standard Expanded Bronze + Vision + Adult Dental - HMO
- Standard Gold - HMO
- Standard Gold + Vision + Adult Dental - HMO
- Standard Silver - HMO
- Standard Silver + Vision + Adult Dental - HMO
- Clear Gold - EPO
- Clear Gold + Vision + Adult Dental - EPO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Elite Silver - EPO
- Elite Silver + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Focused Silver - EPO
- Focused Silver + Vision + Adult Dental - EPO
- Principal Bronze HSA - EPO
- Principal Bronze HSA + Vision + Adult Dental - EPO
- Standard Expanded Bronze - EPO
- Standard Expanded Bronze + Vision + Adult Dental - EPO
- Standard Gold - EPO
- Standard Gold + Vision + Adult Dental - EPO
- Standard Silver - EPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 065655 | MEDICARE UPIN (02) |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 31D1007826
- Facility Type
- Physician Office
- Certificate Effective Date
- January 02, 2025
- Certificate Expiration Date
- January 01, 2027
- Laboratory Director
- ANDREA C. SCUDDER
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Primary Care Medical Practice, Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1912113002, we treat the final digit (2) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 48. The final step is to find the difference between that total and the next multiple of ten (50 - 48 = 2).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 48 is 50. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
WEST PATERSON, NJ 07424
WOODLAND PARK, NJ 07424
WEST PATERSON, NJ 07424
WEST PATERSON, NJ 07424
WEST PATERSON, NJ 07424
WEST PATERSON, NJ 07424
WEST PATERSON, NJ 07424
WOODLAND PARK, NJ 07424
WOODLAND PARK, NJ 07424
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1912113002, enumerated as an "organization" on May 15, 2007.
The provider is located at 1031 MCBRIDE AVE SUITE D 205 WOODLAND PARK, NJ 07424 and the phone number is (973) 237-9055.
Specialist with taxonomy code 174400000X.
The provider might be accepting Accepts: Ambetter Health, Ambetter Health of Delaware,. Please consult your insurance carrier or call the provider to verify.
