Jacques G Losman, M.D.
Individual provider Active NPI Surgery Physician · Elizabeth, NJ
NPI 1063552016 · NPPES record last updated Sep 14, 2010
Key facts
- NPI
- 1063552016
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Surgery Physician 208600000X
- License
- 25MA04496200 (NJ)
- Practice address
- 240 Williamson Street
Suite 104
Elizabeth, NJ 07207 - Phone
- (908) 994-5480
- NPI assigned
- Feb 7, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050722000289 | NJ | Practitioner - General Surgery |
3779510698 | Practice locations: South Orange, NJ |
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Donato a Colavita, MD PA | Surgery | Past | Accepting new patients |
| Medical Associates of Englewood, PC | Past |
Accepting new patients | |
| Jacques G. Losman, MD, PA | Surgery | Past | Accepting new patients |
| Wound Healing of Essex, L.L.C. | Surgery | Past | Accepting new patients |
Interoperability endpoints
- jacquesglosman.jacqueslosman@139495.advancedmd-direct.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 25MA04496200 | NJ | Yes |
Addresses
Primary practice location
240 Williamson Street
Suite 104
Elizabeth, NJ 07207
Mailing address
151 Brentwood Dr
South Orange, NJ 07079-1132
Phone (973) 274-1240
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3710301 | Medicaid | NJ |
Other providers in Elizabeth, NJ
- Marilucy Lopes
- Alberto Lopez Silvero
- Emmanuel Lopez
- Jacqueline Noemi Lopez
- Lizeth Paola Lopez
- Roseline Louis Felisma
- Jazmine Aleyah Love
- Lovereign Care Services LLC
- Luis Benalcazar, MD
- Luna Rehab LLC
All providers in Elizabeth, NJ · Surgery Physician in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 14, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.