Lukasz Polisiakiewicz, D.O.

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

25MB10015800 Issued in NJ

Practice address

141 Route 70 E Ste B
Marlton, NJ 08053-1855

Phone

(856) 596-9057

NPI assigned

Mar 6, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 5

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

Specialty

Pulmonary DiseaseAlso: Internal Medicine

Education

At Still University of Health Sciences, College of Osteo Med, Kirksville, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Virtua Medical Group, PAGroup PAC ID 9830222397, 1,678 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• West Jersey Hospital Hospital, Voorhees, NJ, CCN 310022
• Virtua Mount Holly Hospital Hospital, Mount Holly, NJ, CCN 310057
• Virtua Our Lady of Lourdes Hospital Hospital, Camden, NJ, CCN 310029

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lpolisiakiewicz14171@directvirtua.org

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

• Virtua Medical Group, PA

  • Family Medicine Physician
  • Marlton, NJ
  • NPI 1649226515

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Virtua Medical Group, PA

  • Urgent Care Clinic/Center
  • Sewell, NJ
  • NPI 1720538564
  NPD
• Virtua Medical Group, PA

  • Orthopaedic Surgery Physician
  • Delran, NJ
  • NPI 1841087988
  NPD
• Pulmonary and Sleep Associates of South Jersey, LLC

  • Pulmonary Disease Physician
  • Cherry Hill, NJ
  • NPI 1093734022
  NPD (past)

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

• Virtua - Memorial Hospital Burlington County, Inc.

  • General Acute Care Hospital
  • Mount Holly, NJ
  • NPI 1134125016
  Care Compare affiliation
• Virtua - West Jersey Health System, Inc.

  • General Acute Care Hospital
  • Voorhees, NJ
  • NPI 1528064409
  Care Compare affiliation
• Virtua Our Lady of Lourdes Hospital Inc

  • General Acute Care Hospital
  • Camden, NJ
  • NPI 1235134024
  Care Compare affiliation

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

{
    "created_epoch": "1299369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732060800000",
    "number": "1295033819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 LIPPINCOTT DR STE 410",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080534197",
            "telephone_number": "856-355-0340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 ROUTE 70 E STE B",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080531855",
            "telephone_number": "856-596-9057"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "239 Hurffville Crosskeys Rd Ste 450",
            "address_purpose": "LOCATION",
            "city": "Sewell",
            "state": "NJ",
            "postal_code": "080804009",
            "country_code": "US",
            "telephone_number": "856-341-8390",
            "fax_number": "856-341-8179",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "401 Young Ave Ste 165",
            "address_purpose": "LOCATION",
            "city": "Moorestown",
            "state": "NJ",
            "postal_code": "080573131",
            "country_code": "US",
            "telephone_number": "856-235-4656",
            "fax_number": "856-235-4786",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "412 Ewan Rd Ste E2",
            "address_purpose": "LOCATION",
            "city": "Mullica Hill",
            "state": "NJ",
            "postal_code": "080623707",
            "country_code": "US",
            "telephone_number": "856-596-9051",
            "fax_number": "856-596-0837",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "107 Berlin Rd",
            "address_purpose": "LOCATION",
            "city": "Cherry Hill",
            "state": "NJ",
            "postal_code": "080343526",
            "country_code": "US",
            "telephone_number": "856-429-1800",
            "fax_number": "856-429-1081",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POLISIAKIEWICZ",
        "first_name": "LUKASZ",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-06",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5101019425",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NJ",
            "license": "25MB10015800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0608033",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lpolisiakiewicz14171@directvirtua.org",
            "affiliation": "N",
            "address_1": "412 Ewan Rd Ste E2",
            "city": "Mullica Hill",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080623707",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lpolisiakiewicz14171@directvirtua.org",
            "affiliation": "N",
            "address_1": "141 Route 70 E Ste B",
            "city": "Marlton",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080531855",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lpolisiakiewicz14171@directvirtua.org",
            "affiliation": "N",
            "address_1": "401 Young Ave Ste 165",
            "city": "Moorestown",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080573131",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lpolisiakiewicz14171@directvirtua.org",
            "affiliation": "N",
            "address_1": "239 Hurffville Crosskeys Rd Ste 450",
            "city": "Sewell",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080804009",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lpolisiakiewicz14171@directvirtua.org",
            "affiliation": "N",
            "address_1": "107 Berlin Rd",
            "city": "Cherry Hill",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080343526",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Pulmonary Disease Physician in Marlton, NJ
• Providers in Marlton, NJ by specialty
• Pulmonary Disease Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.