AGILE INFUSION MEDICINE PC — NPI 1972382018 (Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center in HACKENSACK, NJ)

CMS-1500 Box 24J / 33a • NPI

1972382018

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

261QP2300X

Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center

Box 32 Service Location & ZIP+4

5 SUMMIT AVE STE 204, HACKENSACK, NJ, 07601-1271

✓ 9-Digit EDI 837 ZIP+4 (07601-1271)

Practice Phone & Referral Fax

(201) 751-2202

Fax: (201) 266-0437

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1972382018 (AGILE INFUSION MEDICINE PC) 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

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1972382018` (NPI-2 Organization / Facility)
Provider / Legal Name	AGILE INFUSION MEDICINE PC
Plain-English Specialty	Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center NUCC Code: `261QP2300X` (Clinic/Center, Primary Care)
Certifying / Licensing Body	Accreditation Association for Ambulatory Health Care (AAAHC) / CMS
Practice Location Address	5 SUMMIT AVE STE 204, HACKENSACK, NJ, 07601-1271
Practice Telephone / Fax	Tel: (201) 751-2202 \| Fax: (201) 266-0437
Administrative Mailing Address	668 N FOREST DR, TEANECK, NJ, 07666-2047
Enumeration & Last Sync	Enumerated: 2023-09-27 \| CMS Record Updated: 2023-12-06
Authorized Official	JONATHAN WIESEN (Owner)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

5 SUMMIT AVE STE 204, HACKENSACK, NJ, 07601-1271

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Plain-English Taxonomy & CMS Crosswalk (261QP2300X)

What Does Taxonomy Code 261QP2300X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 261QP2300X translates to:
"Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: Accreditation Association for Ambulatory Health Care (AAAHC) / CMS
Clinical Scope: Same-day outpatient consultations, urgent walk-in medical care, vaccinations, and day-case diagnostic procedures.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (AGILE INFUSION MEDICINE PC)

Typical CPT / Diagnostic Procedures:

Walk-In Urgent Care Evaluation, Point-of-Care Testing & X-Ray
Same-Day Ambulatory Endoscopy, Cataract & Minor Surgical Procedures

Common Therapeutic Classes:

Outpatient Oral Antimicrobials, Analgesics, Nebulizers & Vaccines

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`207RP1001X` — Internal Medicine, Pulmonary Disease Plain English: Board-Certified Internist (Adult Diagnostic & Chronic Disease Physician)	State: N/A \| License: `Verified` \| Primary: Secondary
`261QP2300X` — Clinic/Center, Primary Care Plain English: Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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AGILE INFUSION MEDICINE PC (NPI #1972382018)