Individual provider Active NPI

Donna Lifson, MD

  • Internal Medicine Physician
  • Cedar Grove, NJ
National Provider Identifier
1033176227
Registry record updated Sep 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA04607800 Issued in NJ
Practice address
388 Pompton Ave
Cedar Grove, NJ 07009-1814
Phone
(973) 803-0534
NPI assigned
May 1, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MA04607800 NJ Primary

Addresses

Primary practice location

388 Pompton Ave
Cedar Grove, NJ 07009-1814

Mailing address

PO Box 109
Glen Ridge, NJ 07028-0109
Phone (973) 803-0534

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101210000289 NJ Practitioner - Internal MedicinePractitioner - Other (Physician) 1254301187 Reassigns benefits to 1 organization
Practice locations: Cedar Grove, NJ; Livingston, NJ

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA04607800NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kessler Professional Services LLC Past Accepting new patients
Practice Associates,Inc Internal Medicine Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283385600000",
    "number": "1033176227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 109",
            "city": "GLEN RIDGE",
            "state": "NJ",
            "postal_code": "070280109",
            "telephone_number": "973-803-0534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "388 POMPTON AVE",
            "city": "CEDAR GROVE",
            "state": "NJ",
            "postal_code": "070091814",
            "telephone_number": "973-803-0534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIFSON",
        "first_name": "DONNA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-01",
        "last_updated": "2010-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA04607800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Grove, NJ

Sources for this page

Verify at the official NPI Registry.