Individual provider Active NPI

Marko Paul Lujic, MARKO PAUL LUJIC M.D

  • Surgery Physician
  • New Haven, CT
National Provider Identifier
1114230182
Registry record updated Sep 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
55660 Issued in CT
Practice address
20 York St
#T-209 Yale New Haven Hospital
New Haven, CT 06510-3220
Phone
(203) 688-2259
Fax
(203) 688-5599
NPI assigned
Jul 20, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X 55660 CT Primary

Addresses

Primary practice location

20 York St
#T-209 Yale New Haven Hospital
New Haven, CT 06510-3220

Mailing address

25 River Rd
North Haven, CT 06473-4343

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Apr 1, 2024 through Apr 1, 2028

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
55660CTMDSurgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1279584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505174400000",
    "number": "1114230182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 RIVER RD",
            "city": "NORTH HAVEN",
            "state": "CT",
            "postal_code": "064734343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 YORK ST",
            "address_2": "#T-209 YALE NEW HAVEN HOSPITAL",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103220",
            "telephone_number": "203-688-2259",
            "fax_number": "203-688-5599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUJIC",
        "first_name": "MARKO",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "MARKO PAUL LUJIC M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-20",
        "last_updated": "2017-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "CT",
            "license": "55660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.