Individual provider Active NPI

Antoine Alexandra Lespinasse, MD

  • Neonatal-Perinatal Medicine Physician
  • Voorhees, NJ
National Provider Identifier
1114912052
Registry record updated Apr 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
25MA07507600 Issued in NJ
Practice address
1000 Haddonfield Berlin Rd
Suite 210
Voorhees, NJ 08043-3520
Phone
(856) 782-2212
Fax
(856) 782-2266
NPI assigned
Sep 16, 2005
Last updated
Apr 15, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 25MA07507600 NJ
Neonatal-Perinatal Medicine Physician 2080N0001X 25MA07507600 NJ Primary

Addresses

Primary practice location

1000 Haddonfield Berlin Rd
Suite 210
Voorhees, NJ 08043-3520

Mailing address

194 Highland Ave
Montclair, NJ 07042-1914
Phone (973) 746-0250

Other identifiers 2

IdentifierTypeStateIssuer
0024945MedicaidNJ
2085801MedicaidMA

Other names 1

  • Antoine Duvivier Other name

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
I20231024003144 NJ Practitioner - Pediatric Medicine 1355334301 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA07507600NJMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Physician Associates of New Jersey Inc Pediatrics CurrentSince Jul 12, 2023 Accepting new patients
University Physician Associates of New Jersey Inc CurrentSince Jul 12, 2023 Accepting new patients
Boston University Medical Center Radiologists, Inc. Past Accepting new patients
Caritas Medical Group, Inc. Past Accepting new patients
Montclair Hospital LLC Past Accepting new patients

Locations

30 Bergen St
#12
Newark, NJ 07107
Phone (973) 972-0037

90 Bergen St
Newark, NJ 07103
Phone (973) 972-0037

Interoperability endpoints

  • Direct secure messaging: alespinasse189897@ahs.direct-ci.com

Organizations & group practices 5

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": "1126828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555286400000",
    "number": "1114912052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "194 HIGHLAND AVE",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070421914",
            "telephone_number": "973-746-0250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 HADDONFIELD BERLIN RD",
            "address_2": "SUITE 210",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080433520",
            "telephone_number": "856-782-2212",
            "fax_number": "856-782-2266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LESPINASSE",
        "first_name": "ANTOINE",
        "middle_name": "ALEXANDRA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-16",
        "last_updated": "2019-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA07507600",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "NJ",
            "license": "25MA07507600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0024945",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2085801",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANTOINE",
            "last_name": "DUVIVIER",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Voorhees, NJ

Sources for this page

Verify at the official NPI Registry.