Organization Active NPI

Lavender Grove Long Term Care PC

  • Internal Medicine Physician
  • Chatham, NJ
National Provider Identifier
1295528230
Registry record updated Nov 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
LAVENDER GROVE LONG TERM CARE PC
Practice address
35 Runnymede Rd
Chatham, NJ 07928-1331
Phone
(973) 715-3304
Fax
(973) 715-3304
NPI assigned
May 23, 2025
Last updated
Nov 2, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2026

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

Authorized official

Name
Michael LeungNPI 1558305078
Title
Owner
Phone
(973) 715-3304

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

35 Runnymede Rd
Chatham, NJ 07928-1331

Mailing address

50 Albright Cir
Madison, NJ 07940-2630
Phone (973) 715-3304

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, NJ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20250709001008 CT Part B Supplier - Clinic/Group Practice 7113431495 Receives reassigned benefits from 1 practitioner
Practice locations: Shelton, CT
O20260402001668 NJ Part B Supplier - Clinic/Group Practice 7113431495 Receives reassigned benefits from 4 practitioners
Practice locations: Chatham, NJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1747958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1793577600000",
    "number": "1295528230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 ALBRIGHT CIR",
            "city": "MADISON",
            "state": "NJ",
            "postal_code": "079402630",
            "telephone_number": "973-715-3304",
            "fax_number": "973-715-3304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 RUNNYMEDE RD",
            "city": "CHATHAM",
            "state": "NJ",
            "postal_code": "079281331",
            "telephone_number": "973-715-3304",
            "fax_number": "973-715-3304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAVENDER GROVE LONG TERM CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-23",
        "last_updated": "2026-11-02",
        "certification_date": "2026-11-02",
        "status": "A",
        "authorized_official_last_name": "LEUNG",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-715-3304"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chatham, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.