| Elite Concierge Medicine LLC | |
|
414 Eagle Rock Ave Ste 105 West Orange NJ 07052-4229 | |
| (973) 736-1365 | |
| (973) 736-1366 |
| Full Name | Elite Concierge Medicine LLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 414 Eagle Rock Ave Ste 105, West Orange, New Jersey |
| Authorized Official Name and Position | Jamie Baux-johnson (OWNER) |
| Authorized Official Contact | 9737361365 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elite Concierge Medicine LLC 414 Eagle Rock Ave Ste 105 West Orange NJ 07052-4229 Ph: (973) 736-1365 | Elite Concierge Medicine LLC 414 Eagle Rock Ave Ste 105 West Orange NJ 07052-4229 Ph: (973) 736-1365 |
| NPI Number | 1548087844 |
|---|---|
| Provider Enumeration Date | 09/26/2024 |
| Last Update Date | 04/21/2026 |
| Certification Date | 04/21/2026 |
| Medicare PECOS PAC ID | 8325573090 |
|---|---|
| Medicare Enrollment ID | O20241119001972 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548087844 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (NU) | Primary |
| Provider Name | Jamie Baux-johnson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760705719 PECOS PAC ID: 1658540331 Enrollment ID: I20121217000074 |
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