Individual provider Active NPI

Lawrence Charles Antonucci, MD

  • Cardiovascular Disease Physician
  • Chester, NJ
National Provider Identifier
1083684914
Registry record updated Sep 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
25MA04759200 Issued in NJ
Practice address
415 Route 24
Suite E
Chester, NJ 07930
Phone
(908) 879-1500
Fax
(908) 879-1515
NPI assigned
Jan 24, 2006
Last updated
Sep 9, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 25MA04759200 NJ Primary

Addresses

Primary practice location

415 Route 24
Suite E
Chester, NJ 07930

Mailing address

415 Route 24
Suite E
Chester, NJ 07930
Phone (908) 879-1500

Other identifiers 18

IdentifierTypeStateIssuer
0844060OtherCIGNA
2K5143OtherHEALTHNET
3430588OtherAETNA HMO
536P31OtherWELL CHOICE - CHESTER
68334OtherLOCAL 825
0211089000OtherAMERI HEALTH HMO PIN
542139628OtherUNITED HEALTH CARE
IS055OtherOXFORD
010000599500OtherAMERICHOICE
536P32OtherWELL CHOICE - MORRISTOWN
P00064234OtherRR MEDICARE
109881OtherCHN
4232346OtherNON HMO
2198207OtherGHI
62677528OtherMULTI PLAN
16131OtherUHP
303755OtherUS STANLEY
542139628OtherBC/BS

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
I20040427000940 NJ Practitioner - Cardiovascular Disease (Cardiology) 3274520838 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Advanced Cardiology LLCGroup PAC ID 5597751735, 29 clinicians

Practice addresses (Care Compare)

415 Route 24
Suite E
Chester, NJ 07930-2920
Phone (908) 879-1500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.16 of 100Reported as group
Quality
78.12
Promoting interoperability
100
Improvement activities
40
Cost
79.08

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA04759200NJMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lawrence C. Antonucci MD LLC Cardiovascular Disease CurrentSince Jan 14, 2004 Accepting new patients
Advanced Cardiology, LLC Cardiovascular Disease CurrentSince Jun 1, 2025 Accepting new patients
Consensus Medical Group LLC CurrentSince Sep 30, 2019 Accepting new patients
John M Dalena and Darren R Blumberg MD LLC PastSince Oct 1, 2010 Accepting new patients
Cardiovascular Health Consultants, P.a. Past Accepting new patients
Premier Cardiovascular Associates, P.C. Past Accepting new patients
Garden State Urology LLC Past Accepting new patients
CMG Medical Group I LLC Past Accepting new patients

Locations

65 Ridgedale Ave
Cedar Knolls, NJ 07927
Phone (908) 979-1302

415 Route 24
Ste E
Chester, NJ 07930
Phone (908) 879-1500

706 Bergen Ave
Ste 2
Jersey City, NJ 07306
Phone (201) 464-8888

420 Bridge Plaza Dr
Manalapan, NJ 07726
Phone (732) 536-8008

100 Madison Ave
Morristown, NJ 07960
Phone (973) 538-5210

21 Perry St
Ste 1
Morristown, NJ 07960
Phone (973) 285-9300

95 Madison Ave
Ste B01
Morristown, NJ 07960
Phone (973) 267-6474

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/uc35130_gardenstateurology

Organizations & group practices 8

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

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1138060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378684800000",
    "number": "1083684914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 ROUTE 24",
            "address_2": "SUITE E",
            "city": "CHESTER",
            "state": "NJ",
            "postal_code": "07930",
            "telephone_number": "908-879-1500",
            "fax_number": "908-879-1515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 ROUTE 24",
            "address_2": "SUITE E",
            "city": "CHESTER",
            "state": "NJ",
            "postal_code": "07930",
            "telephone_number": "908-879-1500",
            "fax_number": "908-879-1515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTONUCCI",
        "first_name": "LAWRENCE",
        "middle_name": "CHARLES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-24",
        "last_updated": "2013-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NJ",
            "license": "25MA04759200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "0844060",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "2K5143",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "3430588",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELL CHOICE - CHESTER",
            "identifier": "536P31",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LOCAL 825",
            "identifier": "68334",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERI HEALTH HMO PIN",
            "identifier": "0211089000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "542139628",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "IS055",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICHOICE",
            "identifier": "010000599500",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELL CHOICE - MORRISTOWN",
            "identifier": "536P32",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00064234",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHN",
            "identifier": "109881",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NON HMO",
            "identifier": "4232346",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "2198207",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MULTI PLAN",
            "identifier": "62677528",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHP",
            "identifier": "16131",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US STANLEY",
            "identifier": "303755",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "542139628",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chester, NJ

Sources for this page

Verify at the official NPI Registry.