Ishitani Health Center is a medicare enrolled "Clinic/center - Multi-specialty" provider in Fort Lee, New Jersey. Their current practice location is
1600 Parker Ave Ste 1, Fort Lee, New Jersey. You can reach out to their office (for appointments etc.) via phone at
(201) 302-9993.
Ishitani Health Center is licensed to practice in NU (license number ) and it also participates in the medicare program. Ishitani Health Center
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1164240156.
Healthcare Provider's Profile
| Full Name | Ishitani Health Center |
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| Type | Facility |
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| Speciality | Clinic/center - Multi-specialty |
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| Location | 1600 Parker Ave Ste 1, Fort Lee, New Jersey |
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| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1164240156
- Provider Enumeration Date: 09/30/2024
- Last Update Date: 04/26/2025
Medicare PECOS Information:
- PECOS PAC ID: 7315468808
- Enrollment ID: O20250313001104
Medical Identifiers
Medical identifiers for Ishitani Health Center such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1164240156 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 111N00000X | Chiropractor | (NU) | Secondary |
| 261QM1300X | Clinic/center - Multi-specialty | (NU) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Ishitani Health Center acts as a billing entity for following providers:
| Provider Name | Sun H Park |
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| Provider Type | Practitioner - Chiropractic |
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| Provider Identifiers | NPI Number: 1801326152
PECOS PAC ID: 6507136306
Enrollment ID: I20170727001618 |
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| Provider Name | Roger Mitchell |
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| Provider Type | Practitioner - Chiropractic |
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| Provider Identifiers | NPI Number: 1326562034
PECOS PAC ID: 6103198692
Enrollment ID: I20190722003436 |
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| Provider Name | Yoonho Shin |
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| Provider Type | Practitioner - Chiropractic |
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| Provider Identifiers | NPI Number: 1326671363
PECOS PAC ID: 8921547423
Enrollment ID: I20240828003213 |
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| Provider Name | Sophia Ma |
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| Provider Type | Practitioner - Physical Therapist In Private Practice |
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| Provider Identifiers | NPI Number: 1568828598
PECOS PAC ID: 6507168127
Enrollment ID: I20250529002465 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ishitani Health Center is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Ishitani Health Center
117 Morningside Lane, Unit A,
Palisades Park, NJ 07650
Ph: (917) 690-4730 | Ishitani Health Center
1600 Parker Ave Ste 1,
Fort Lee, NJ 07024-7050
Ph: (201) 302-9993 |
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