Mark Lister, M.D., PA

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

25MA04176200 Issued in NJ

Legal business name

MARK LISTER, M.D., PA

Practice address

495 N 13TH St
Newark, NJ 07107-1317

Phone

(973) 844-1340

Fax

(973) 450-5964

NPI assigned

Apr 14, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Mark Anthony Lister, M.D.NPI 1043258353

Title

Owner

Phone

(973) 844-1340

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mark Anthony Lister, M.D.

  • Ophthalmology Physician
  • Belleville, NJ
  • NPI 1043258353
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1239667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240185600000",
    "number": "1003059536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "495 N 13TH ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071071317",
            "telephone_number": "973-844-1340",
            "fax_number": "973-450-5964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 N 13TH ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071071317",
            "telephone_number": "973-844-1340",
            "fax_number": "973-450-5964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK LISTER, M.D., PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-14",
        "last_updated": "2009-04-20",
        "status": "A",
        "authorized_official_last_name": "LISTER",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-844-1340",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "NJ",
            "license": "25MA04176200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1515608",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marie C Friedman JD LCSW Lcadc LLC
• Matthew Gruen Marin, M.D.
• Lori Marino, PA
• Marion P. Thomas Charter High School
• Mark Granata, DPM
• Mark Pollack OD PA
• Mark V Russo, DC, LLC
• Janet Mark
• Kenneth Joel Markowitz, DDS
• Maryanne Markowski, CNM

• Ophthalmology Physician in Newark, NJ
• Providers in Newark, NJ by specialty
• Ophthalmology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.