CMS-1500 Box 24J / 33a • NPI
1386829778
Type 2 Organization (Box 32a/33a)
HIPAA NUCC Taxonomy • CMS Code
173000000X
Licensed & Credentialed Legal Medicine
Box 32 Service Location & ZIP+4
347 LYONS AVE, NEWARK, NJ, 07112-1440
✓ 9-Digit EDI 837 ZIP+4 (07112-1440)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1386829778 (347 LYONS AVENUE MEDICAL CENTER LLC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1386829778 (NPI-2 Organization / Facility) |
|---|---|
| Provider / Legal Name | 347 LYONS AVENUE MEDICAL CENTER LLC |
| Plain-English Specialty | Licensed & Credentialed Legal Medicine NUCC Code: 173000000X (Legal Medicine) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 347 LYONS AVE, NEWARK, NJ, 07112-1440 |
| Practice Telephone / Fax | Tel: (973) 923-5771 | Fax: (973) 923-0532 |
| Administrative Mailing Address | 62 WILLIAMSON AVE, HILLSIDE, NJ, 07205-1606 |
| Enumeration & Last Sync | Enumerated: 2008-01-03 | CMS Record Updated: 2008-01-03 |
| Authorized Official | IRVIN MUSE (OWNER) |
Clinic Location, Accessibility & Directions
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Plain-English Taxonomy & CMS Crosswalk (173000000X)
What Does Taxonomy Code 173000000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 173000000X translates to:
"Licensed & Credentialed Legal Medicine"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (347 LYONS AVENUE MEDICAL CENTER LLC)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
173000000X — Legal MedicinePlain English: Licensed & Credentialed Legal Medicine | State: N/A | License: Verified | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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