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

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Ennoble HC NJ PC is a medicare enrolled primary clinic (Family Medicine - Geriatric Medicine) in Hackensack, New Jersey. The current practice location for Ennoble HC NJ PC is 2 University Plz, Hackensack, New Jersey. For appointments, you can reach them via phone at (973) 435-9463. The mailing address for Ennoble HC NJ PC is 2 University Plaza Drive, Suite 204, Hackensack, New Jersey and phone number is (973) 241-1356.

Ennoble HC NJ PC is licensed to practice in (license number ). The clinic also participates in the medicare program and its NPI number is 1306500764. 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 (973) 435-9463.

Contact Information

Ennoble HC NJ PC
2 University Plz
Hackensack
NJ 07601-6202
(973) 435-9463
Not Available

Map and Direction


Primary Care Clinic Profile

Full NameEnnoble HC NJ PC
SpecialityFamily Medicine
Location2 University Plz, Hackensack, New Jersey
Authorized Official Name and PositionKushabhadra Das (CEO)
Authorized Official Contact8628129010
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 PC
2 University Plaza Drive
Suite 204
Hackensack
NJ 07601

Ph: (973) 241-1356		Ennoble HC NJ PC
2 University Plz
Hackensack
NJ 07601-6202

Ph: (973) 435-9463

NPI Details:

NPI Number1306500764
Provider Enumeration Date10/22/2021
Last Update Date11/04/2026
Certification Date11/04/2026

Medicare PECOS Information:

Medicare PECOS PAC ID0345638185
Medicare Enrollment IDO20211027000609

Medical Identifiers

Medical identifiers for Ennoble HC NJ PC such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1306500764NPI-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 PC acts as a billing entity for following providers:
Provider NamePaul E Austermehle
Provider TypePractitioner - Physician Assistant
Provider IdentifiersNPI Number: 1710919410
PECOS PAC ID: 3971490616
Enrollment ID: I20041201000339
Provider NameMary Eileen Mcsorley
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1023150570
PECOS PAC ID: 4385677475
Enrollment ID: I20050919000470
Provider NameLael Little
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1730494980
PECOS PAC ID: 1759560279
Enrollment ID: I20110128000757
Provider NameJessica a Rowland
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1659641769
PECOS PAC ID: 7517124076
Enrollment ID: I20120210000546
Provider NameAnzhela Kogan
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1871865899
PECOS PAC ID: 4688991912
Enrollment ID: I20150326000834
Provider NameDiane Tumolo
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1902340813
PECOS PAC ID: 4880964436
Enrollment ID: I20170714001461
Provider NameNatalie Graziani
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1447737010
PECOS PAC ID: 6709136807
Enrollment ID: I20180911003751
Provider NamePradhan Shivananda Sharma
Provider TypePractitioner - Physician Assistant
Provider IdentifiersNPI Number: 1770033714
PECOS PAC ID: 2668723404
Enrollment ID: I20180918003193
Provider NameLauren Carruth Mehnert
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1477687200
PECOS PAC ID: 3779587811
Enrollment ID: I20190114000176
Provider NameAnnette M Redguard
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1659720290
PECOS PAC ID: 9739428178
Enrollment ID: I20190304000555
Provider NameTheresa Mary Cleary
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1548737505
PECOS PAC ID: 3870832033
Enrollment ID: I20190305003061
Provider NamePaul Mensah
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1629695036
PECOS PAC ID: 1052737459
Enrollment ID: I20200817001067
Provider NameNicole Shiko
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1376107839
PECOS PAC ID: 8921333287
Enrollment ID: I20201211000456
Provider NameChristina Danielle Nevins
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1245844893
PECOS PAC ID: 5395158646
Enrollment ID: I20210106002053
Provider NameMichelle Lu
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1750856803
PECOS PAC ID: 9133559669
Enrollment ID: I20210609003280
Provider NamePatricia E Markovitz
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1932530078
PECOS PAC ID: 7214337229
Enrollment ID: I20210614002297
Provider NamePatrice Nicole Harris
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1790440717
PECOS PAC ID: 0648660795
Enrollment ID: I20211202003129
Provider NameEmily Froggatt
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1861155244
PECOS PAC ID: 7911397898
Enrollment ID: I20211208001782
Provider NameHolly Bonner
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1720484181
PECOS PAC ID: 4981911724
Enrollment ID: I20220517002580
Provider NameCaroline Wilkinson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1104474394
PECOS PAC ID: 0648653162
Enrollment ID: I20220816003924
Provider NameJennifer Clerisson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1730624651
PECOS PAC ID: 5395120778
Enrollment ID: I20220921001955
Provider NameThomas Lee
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1285632950
PECOS PAC ID: 7214997014
Enrollment ID: I20230522000001
Provider NameKettia Delisfort
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1790481596
PECOS PAC ID: 0345608048
Enrollment ID: I20230627002238
Provider NameKathryn Maceyko
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1760856736
PECOS PAC ID: 1658728993
Enrollment ID: I20231108002908
Provider NameCristina Conly
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1629779921
PECOS PAC ID: 7911350038
Enrollment ID: I20240125000481
Provider NameNafisa Chowdhury
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1386354892
PECOS PAC ID: 4880034578
Enrollment ID: I20240429001284
Provider NameAdunni Ward
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1477217180
PECOS PAC ID: 5193163731
Enrollment ID: I20240601000201
Provider NameAmandeep Singh
Provider TypePractitioner - Physician Assistant
Provider IdentifiersNPI Number: 1053821215
PECOS PAC ID: 5395110266
Enrollment ID: I20240616000069
Provider NameKatherine Denise Tucker
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1215775622
PECOS PAC ID: 8921530429
Enrollment ID: I20241022000156
Provider NameMichelle Lynne Updegraff
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1033938410
PECOS PAC ID: 5395278477
Enrollment ID: I20241028003275
Provider NameBenyam Alemneh
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1205662772
PECOS PAC ID: 6901330067
Enrollment ID: I20241112001621
Provider NameShannon Hendrickson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1568278026
PECOS PAC ID: 9032647516
Enrollment ID: I20250113000049
Provider NameChayla Brown
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1801667290
PECOS PAC ID: 8022458181
Enrollment ID: I20250714002302
Provider NameNikkira Townsend
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1447098231
PECOS PAC ID: 5799214086
Enrollment ID: I20250721002658
Provider NameLauren Good Crump
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1699473264
PECOS PAC ID: 8224530050
Enrollment ID: I20250909002264
Provider NameArlinda a Ryals
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1235016650
PECOS PAC ID: 9436656709
Enrollment ID: I20251010003624
Provider NameMercedes Quentasia-denise Harris
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1760357081
PECOS PAC ID: 0648762500
Enrollment ID: I20251126003608
Provider NameAyesha C Chiem
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1073349262
PECOS PAC ID: 7810482817
Enrollment ID: I20251217002181
Provider NameRenee Elizabeth Kravchak
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1730057779
PECOS PAC ID: 4486149218
Enrollment ID: I20251219000716
Provider NameNicole Foster
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1841998796
PECOS PAC ID: 6507343845
Enrollment ID: I20260116003813
Provider NameAlysha Fisher
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1033080049
PECOS PAC ID: 6800373606
Enrollment ID: I20260122004231
Provider NameSara Dunne
Provider TypePractitioner - Physician Assistant
Provider IdentifiersNPI Number: 1053671859
PECOS PAC ID: 1355597188
Enrollment ID: I20260129003986
Provider NameFrancine Fleming
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1538025804
PECOS PAC ID: 6901385004
Enrollment ID: I20260209004065
Provider NameKadyija Caressa Lawrence
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1619704129
PECOS PAC ID: 7719461516
Enrollment ID: I20260319002460
Provider NameChelsea Sonnelitter
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1861205189
PECOS PAC ID: 3971079849
Enrollment ID: I20260417001483
Provider NameAndrea Faller
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1396512877
PECOS PAC ID: 4082054028
Enrollment ID: I20260528004723
Provider NameMark Bradshaw
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1316107428
PECOS PAC ID: 6608049275
Enrollment ID: I20260602000141
Provider NameGil Roter
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1073621231
PECOS PAC ID: 1153313762
Enrollment ID: I20260602004166
Provider NameLura Auel
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1316758584
PECOS PAC ID: 5193298735
Enrollment ID: I20260624004245

Reviews and Comments

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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.