Organization Active NPI

Marek R. Lupicki MD PC

  • General Practice Physician
  • Old Bridge, NJ
National Provider Identifier
1053560128
Registry record updated Dec 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
MAREK R. LUPICKI MD PC
Practice address
200 Perrine Road
Suite 211
Old Bridge, NJ 08857-2836
Phone
(732) 553-1000
Fax
(732) 553-1003
NPI assigned
Sep 15, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2008

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

Authorized official

Name
Dr. Marek Robert Lupicki, MDNPI 1508967746
Title
President
Phone
(732) 553-1000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

200 Perrine Road
Suite 211
Old Bridge, NJ 08857-2836

Mailing address

200 Perrine Rd
Suite 211
Old Bridge, NJ 08857-2842
Phone (732) 553-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050107000091 NJ Part B Supplier - Clinic/Group Practice 5597713487 Receives reassigned benefits from 1 practitioner
Practice locations: Old Bridge, NJ

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
31D0969498Marek R Lupicki MD PC200 Perrine Road Suite 211, Old Bridge, NJ 08857Certificate of waiverJan 17, 2028

National Provider Directory

National Provider Directory

Locations

111 Route 516
Old Bridge, NJ 08857
Phone (732) 254-8200

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1221436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1229040000000",
    "number": "1053560128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 PERRINE RD",
            "address_2": "SUITE 211",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "088572842",
            "telephone_number": "732-553-1000",
            "fax_number": "732-553-1003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 PERRINE ROAD",
            "address_2": "SUITE 211",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "088572836",
            "telephone_number": "732-553-1000",
            "fax_number": "732-553-1003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAREK R. LUPICKI MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-15",
        "last_updated": "2008-12-12",
        "status": "A",
        "authorized_official_last_name": "LUPICKI",
        "authorized_official_first_name": "MAREK",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "732-553-1000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Old Bridge, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.