Individual provider Active NPI

Lisa Andujar, RN

  • High-Risk Obstetric Registered Nurse
  • Suffern, NY
National Provider Identifier
1104672567
Registry record updated Apr 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
High-Risk Obstetric Registered NurseTaxonomy code 163WX0002X
License
409546 Issued in NY
Practice address
15 Suffern PL Ste a
Suffern, NY 10901-5566
Phone
(845) 357-4500
NPI assigned
Apr 26, 2024
Last updated
Apr 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
High-Risk Obstetric Registered Nurse 163WX0002X 409546 NY Primary

Addresses

Primary practice location

15 Suffern PL Ste a
Suffern, NY 10901-5566

Mailing address

214 Homestead Village Dr
Warwick, NY 10990-4218
Phone (347) 739-3104

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
409546NYMDHigh-Risk Obstetric Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
J&D Ultracare Corp CurrentSince Apr 28, 2024 Accepting new patients

Locations

15 Suffern Pl
Ste A
Suffern, NY 10901
Phone (845) 357-4500

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1714089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714089600000",
    "number": "1104672567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 HOMESTEAD VILLAGE DR",
            "city": "WARWICK",
            "state": "NY",
            "postal_code": "109904218",
            "telephone_number": "347-739-3104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 SUFFERN PL STE A",
            "city": "SUFFERN",
            "state": "NY",
            "postal_code": "109015566",
            "telephone_number": "845-357-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDUJAR",
        "first_name": "LISA",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-26",
        "last_updated": "2024-04-26",
        "certification_date": "2024-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WX0002X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Obstetric, High-Risk",
            "state": "NY",
            "license": "409546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suffern, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.