Ennoble HC NJ III PC - Medicare Primary Care in Hackensack, NJ

  1. Home
  2. Primary Care Clinics
  3. NJ
  4. Hackensack
Ennoble HC NJ III PC is a medicare enrolled primary clinic (Family Medicine - Geriatric Medicine) in Hackensack, New Jersey. The current practice location for Ennoble HC NJ III PC is 2 University Plz Ste 204, Hackensack, New Jersey. For appointments, you can reach them via phone at (551) 295-8223. The mailing address for Ennoble HC NJ III PC is 2 University Plz Ste 204, Hackensack, New Jersey and phone number is (551) 295-8223.

Ennoble HC NJ III PC is licensed to practice in (license number ). The clinic also participates in the medicare program and its NPI number is 1043192099. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (551) 295-8223.

Contact Information

Ennoble HC NJ III PC
2 University Plz Ste 204
Hackensack
NJ 07601-6211
(551) 295-8223
Not Available

Map and Direction


Primary Care Clinic Profile

Full NameEnnoble HC NJ III PC
SpecialityFamily Medicine
Location2 University Plz Ste 204, Hackensack, New Jersey
Authorized Official Name and PositionMark Bradshaw (OWNER)
Authorized Official Contact6786652618
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Ennoble HC NJ III PC
2 University Plz Ste 204
Hackensack
NJ 07601-6211

Ph: (551) 295-8223		Ennoble HC NJ III PC
2 University Plz Ste 204
Hackensack
NJ 07601-6211

Ph: (551) 295-8223

NPI Details:

NPI Number1043192099
Provider Enumeration Date07/22/2025
Last Update Date08/29/2025
Certification Date08/29/2025

Medicare PECOS Information:

Medicare PECOS PAC ID5294238531
Medicare Enrollment IDO20250911004607

Medical Identifiers

Medical identifiers for Ennoble HC NJ III PC such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1043192099NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207QG0300XFamily Medicine - Geriatric Medicine ()Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Ennoble HC NJ III PC acts as a billing entity for following providers:
Provider NameMichelle Rene Reisner
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1942267158
PECOS PAC ID: 7012800915
Enrollment ID: I20040204000927
Provider NameStacey Laurito
Provider TypePractitioner - Physician Assistant
Provider IdentifiersNPI Number: 1114980729
PECOS PAC ID: 5294706032
Enrollment ID: I20040804000927
Provider NameHerbert Williams
Provider TypePractitioner - Physician Assistant
Provider IdentifiersNPI Number: 1982610895
PECOS PAC ID: 4486621240
Enrollment ID: I20040913000538
Provider NameThomas Lee
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1285632950
PECOS PAC ID: 7214997014
Enrollment ID: I20041015000718
Provider NameLauren Carruth Mehnert
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1477687200
PECOS PAC ID: 3779587811
Enrollment ID: I20060905000136
Provider NameNelson P Gramatica
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1316027642
PECOS PAC ID: 1658371166
Enrollment ID: I20070108000204
Provider NameMaria E Mejia
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1609895036
PECOS PAC ID: 9335243971
Enrollment ID: I20070409000424
Provider NameIna Paternostro
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1861678716
PECOS PAC ID: 4981783412
Enrollment ID: I20080508000284
Provider NameJosephine C Westenberger
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1679624605
PECOS PAC ID: 6305918368
Enrollment ID: I20080708000429
Provider NameKimo M Morris-lowe
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1932369345
PECOS PAC ID: 9436210176
Enrollment ID: I20081212000431
Provider NameChristine A. C. Forward
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1780687004
PECOS PAC ID: 8729113030
Enrollment ID: I20100311000719
Provider NameErin M Chini
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1609013267
PECOS PAC ID: 9335295732
Enrollment ID: I20100407000124
Provider NameHeather Zeveney
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1710281720
PECOS PAC ID: 6709063969
Enrollment ID: I20110615000859
Provider NameMarina Bloshteyn
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1801144811
PECOS PAC ID: 3274772058
Enrollment ID: I20130627000334
Provider NameElease E Coney
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1851727150
PECOS PAC ID: 7214169705
Enrollment ID: I20140416000435
Provider NameLael Little
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1730494980
PECOS PAC ID: 1759560279
Enrollment ID: I20141008000125
Provider NameChristopher Johnstone
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1083041214
PECOS PAC ID: 4981825908
Enrollment ID: I20141016000821
Provider NameHeather C Wilmore
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1194123133
PECOS PAC ID: 4981920626
Enrollment ID: I20150224001112
Provider NameMark D Kraljevich
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1538591052
PECOS PAC ID: 6305146986
Enrollment ID: I20151203002594
Provider NameAaron E Roth
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1710985379
PECOS PAC ID: 5890989693
Enrollment ID: I20160217001492
Provider NameMichelle M Giles-honore
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1023416898
PECOS PAC ID: 9234427915
Enrollment ID: I20161012001949
Provider NameAndrea L Spinelli-haag
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1548761075
PECOS PAC ID: 3072874262
Enrollment ID: I20180305000863
Provider NameMichael Albert Morale
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1053846782
PECOS PAC ID: 5092062356
Enrollment ID: I20180718002888
Provider NameEsther Neff Mermelstein
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1114448776
PECOS PAC ID: 1759633373
Enrollment ID: I20181010000633
Provider NameAnn M Foster
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1912480609
PECOS PAC ID: 7810231057
Enrollment ID: I20181129000967
Provider NameJennifer L Brooks
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1992154132
PECOS PAC ID: 3274878343
Enrollment ID: I20181218000705
Provider NameBreshelle Brown
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1912470519
PECOS PAC ID: 5698014116
Enrollment ID: I20190228000705
Provider NameZachariah G Smith
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1699265132
PECOS PAC ID: 3971843277
Enrollment ID: I20190325000951
Provider NameGabrielle D Jimenez
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1457812026
PECOS PAC ID: 4880935923
Enrollment ID: I20190418000099
Provider NameRoslyn Marie Hill
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1407310865
PECOS PAC ID: 4688917206
Enrollment ID: I20190523000883
Provider NameDenise Kimberly Rozzelle
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1306203633
PECOS PAC ID: 4385978188
Enrollment ID: I20190627003266
Provider NameNicole Shiko
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1376107839
PECOS PAC ID: 8921333287
Enrollment ID: I20190710000769
Provider NameTherese Piasecki
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1811469703
PECOS PAC ID: 9537498548
Enrollment ID: I20190916003064
Provider NameAllyssa Perez
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1679926539
PECOS PAC ID: 1355773417
Enrollment ID: I20191112002291
Provider NameAnna M Comayagua
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1710529151
PECOS PAC ID: 4880022318
Enrollment ID: I20200403000042
Provider NameBetty Danquah-asare
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1841820081
PECOS PAC ID: 8820410442
Enrollment ID: I20200626001056
Provider NameJacquelene Vertus
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1710511423
PECOS PAC ID: 8921428665
Enrollment ID: I20201019000279
Provider NameCourtney Destefano
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1780219410
PECOS PAC ID: 1254741226
Enrollment ID: I20201102002195
Provider NameSuzett Shaw
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1184171639
PECOS PAC ID: 7113338112
Enrollment ID: I20201124000032
Provider NameShirielle T Avakian
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1861092009
PECOS PAC ID: 9335551324
Enrollment ID: I20201216000984
Provider NameGenalyn Vargas
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1790260180
PECOS PAC ID: 2567877350
Enrollment ID: I20210208002125
Provider NameSoraya Michelle St. Louis-augustin
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1720664329
PECOS PAC ID: 2163831462
Enrollment ID: I20210517000491
Provider NameMarva Mitchell Sprual
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1164030045
PECOS PAC ID: 5193120707
Enrollment ID: I20210819003054
Provider NameVictoria Ann D'amico
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1689047516
PECOS PAC ID: 0648677617
Enrollment ID: I20210920000807
Provider NameAnastasia Alosi
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1881352565
PECOS PAC ID: 1254722663
Enrollment ID: I20211220000405
Provider NameLisa Knisley
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1114261054
PECOS PAC ID: 5294968590
Enrollment ID: I20220107000330
Provider NameAnara Hamded
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1740923234
PECOS PAC ID: 1456739242
Enrollment ID: I20220607002397
Provider NameBrittany Zikos
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1609505734
PECOS PAC ID: 7113308222
Enrollment ID: I20220721000354
Provider NameMary Kristelyn Ann Asok
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1891447280
PECOS PAC ID: 0042694382
Enrollment ID: I20220906000250
Provider NameDeborah L Macy
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1811559875
PECOS PAC ID: 3870960404
Enrollment ID: I20221110000969
Provider NameTamara King Morrieson
Provider TypePractitioner - Certified Clinical Nurse Specialist (cns)
Provider IdentifiersNPI Number: 1922716919
PECOS PAC ID: 7911376884
Enrollment ID: I20221215001961
Provider NameJean M Vitiello
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1982320230
PECOS PAC ID: 9638541816
Enrollment ID: I20230216001701
Provider NameRachel Rowlinson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1164132585
PECOS PAC ID: 6800253287
Enrollment ID: I20230530001524
Provider NameNontika Blango
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1376227587
PECOS PAC ID: 2769842616
Enrollment ID: I20230724002783
Provider NameJessica a Rowland
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1659641769
PECOS PAC ID: 7517124076
Enrollment ID: I20231104000650
Provider NameJohanna Laszloczky
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1821786229
PECOS PAC ID: 9032560982
Enrollment ID: I20240104004435
Provider NamePaula Saint
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1174395255
PECOS PAC ID: 4385096981
Enrollment ID: I20240119000260
Provider NameAndrea Faller
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1396512877
PECOS PAC ID: 4082054028
Enrollment ID: I20240424003233
Provider NameLauren M. Deiudicibus
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1457115826
PECOS PAC ID: 2062854441
Enrollment ID: I20240530003330
Provider NameSusan Dolphin
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1366286403
PECOS PAC ID: 2264979665
Enrollment ID: I20240802002332
Provider NameRobin Glanton
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1306678727
PECOS PAC ID: 6305370933
Enrollment ID: I20241105002945
Provider NameKeary Hinds
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1467157925
PECOS PAC ID: 4284162116
Enrollment ID: I20250106003365
Provider NameJalicia Lashawn Grant
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1790173953
PECOS PAC ID: 6406377951
Enrollment ID: I20250312004110
Provider NameCasandra Morinvil
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1811702731
PECOS PAC ID: 9436673753
Enrollment ID: I20250408003235
Provider NameJoudlie Jean
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1467252395
PECOS PAC ID: 0345750410
Enrollment ID: I20250609000154
Provider NameKathleen Cummings
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1124886858
PECOS PAC ID: 3971016700
Enrollment ID: I20250703000706
Provider NameAmber Shereece Hart
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1518760974
PECOS PAC ID: 9931617974
Enrollment ID: I20250801001489
Provider NameMegha Desai
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1952196792
PECOS PAC ID: 8123520616
Enrollment ID: I20250904002575
Provider NameGregorie Acceus
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1336021930
PECOS PAC ID: 1658873112
Enrollment ID: I20250904005068
Provider NameLesley Majoni
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1306717798
PECOS PAC ID: 8224525803
Enrollment ID: I20251016002274
Provider NamePatrick Xavier Crowley
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1831072800
PECOS PAC ID: 6608364799
Enrollment ID: I20251021003312
Provider NameJasmyne S Moore
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1184514267
PECOS PAC ID: 0345730313
Enrollment ID: I20251107001703
Provider NameSamantha Michelle Weber
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1598015687
PECOS PAC ID: 7315240389
Enrollment ID: I20251118002844
Provider NameMark Bradshaw
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1316107428
PECOS PAC ID: 6608049275
Enrollment ID: I20260105003445
Provider NameChristine Marie Meudt
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1720947369
PECOS PAC ID: 2668952300
Enrollment ID: I20260212003482
Provider NamePerrie Netzer
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1821852963
PECOS PAC ID: 5991286783
Enrollment ID: I20260219002523
Provider NameElizabeth Sobeck
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1023968443
PECOS PAC ID: 5395210074
Enrollment ID: I20260409003637
Provider NameElena Molotchkov
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1447191739
PECOS PAC ID: 1759858996
Enrollment ID: I20260424003470
Provider NameBreeana W Dickson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1003630468
PECOS PAC ID: 2769951193
Enrollment ID: I20260515000007
Provider NameKanwal Khan
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1508662008
PECOS PAC ID: 9638692577
Enrollment ID: I20260601001756
Provider NameBrenna Melick
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1053250167
PECOS PAC ID: 6406329549
Enrollment ID: I20260622000529

Reviews and Comments

Other Primary Care Clinics in Hackensack, NJ

Hackensack Digestive Disease Associates, P.A.
Primary Care Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 52 1st St, Hackensack, NJ 07601
Phone: 201-488-3003    Fax: 201-488-6911
893 Medical LLC
Primary Care Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 5 Summit Ave Ste 106, Hackensack, NJ 07601
Phone: 201-212-5733    
Mms Healthcare Management LLC
Primary Care Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 241 Main St Fl 4, Hackensack, NJ 07601
Phone: 201-996-9035    
Progressive Medical Services PC
Primary Care Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 560 Hudson St Ste 301, Hackensack, NJ 07601
Phone: 201-641-2125    Fax: 212-888-6024
Usk Management Corporation
Primary Care Clinic
Medicare: Medicare Enrolled
Practice Location: 150 River St Apt 252, Hackensack, NJ 07601
Phone: 732-523-4057    
David P. Bleeker MD
Primary Care Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 211 Essex St, Suite 401, Hackensack, NJ 07601
Phone: 201-487-1711    Fax: 201-487-3377

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.