Ennoble Hc Nj III PC
NPI 1043192099 · Geriatric Medicine (Family Medicine) Physician · Hackensack, NJ
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Ennoble Hc Nj III PC is a Geriatric Medicine (Family Medicine) Physician organization in Hackensack, NJ (NPI 1043192099).
Provider details
- NPI number
- 1043192099
- Entity type
- Organization
- Primary specialty
- Geriatric Medicine (Family Medicine) PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Mark Bradshaw, Owner(678) 665-2618
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
1 yr in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
6 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Additional practice locations (5)
- 1000 Haddonfield Berlin Rd Ste 205Voorhees, NJ 08043-3520Phone: (973) 241-1356
- 3209 S Broadway Ste 229Edmond, OK 73013-4064Phone: (551) 295-8223
- 101 W Hefner RdOklahoma City, OK 73114-6631Phone: (405) 896-8058
- 101 Greenwood Ave Ste 140Jenkintown, PA 19046-2627Phone: (973) 241-1356
- 325 Chestnut St Ste 800Philadelphia, PA 19106-2608Phone: (973) 241-1356
Registry dates
- Enumerated
- 2025-07-22
- Last updated
- 2025-08-29
- Certified
- 2025-08-29
Frequently asked questions
- What is Ennoble Hc Nj III PC's NPI number?
- Ennoble Hc Nj III PC's National Provider Identifier (NPI) is 1043192099, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Ennoble Hc Nj III PC?
- Ennoble Hc Nj III PC is classified in the NPPES registry as Geriatric Medicine (Family Medicine) Physician (Allopathic & Osteopathic Physicians).
- Where is Ennoble Hc Nj III PC located?
- Ennoble Hc Nj III PC's practice location on file with NPPES is 2 University Plz Ste 204, Hackensack, NJ 07601-6211.
- What is Ennoble Hc Nj III PC's phone number?
- The practice phone number listed in the NPPES registry for Ennoble Hc Nj III PC is (551) 295-8223.
- Does Ennoble Hc Nj III PC accept Medicare?
- Ennoble Hc Nj III PC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Ennoble Hc Nj III PC?
- The authorized official listed on Ennoble Hc Nj III PC's NPPES record is Mark Bradshaw, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Ennoble Hc Nj III PC's NPI active?
- Yes — Ennoble Hc Nj III PC's NPI (1043192099) is active in the NPPES registry as of the last update on 2025-08-29.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.