Individual provider Active NPI

Lawrence S Kluger, MD

  • Gastroenterology Physician
  • Warren, NJ
National Provider Identifier
1396792776
Registry record updated May 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
MA39126 Issued in NJ
Practice address
35 Ellsworth Dr
Warren, NJ 07059-7137
Phone
(732) 563-1155
Fax
(732) 563-1156
NPI assigned
May 30, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 29, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X MA39126 NJ Primary

Addresses

Primary practice location

35 Ellsworth Dr
Warren, NJ 07059-7137

Mailing address

35 Ellsworth Dr
Warren, NJ 07059-7137
Phone (732) 563-1155

Other identifiers 1

IdentifierTypeStateIssuer
0990001MedicaidNJ

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
I20160219001711 NJ Order and Referring Only - GastroenterologyPractitioner - Gastroenterology 6204740756

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA39126NJMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Consensus Medical Group LLC PastSince Jan 19, 2020 Accepting new patients
Gastromed Healthcare, P.a. Gastroenterology PastSince May 20, 2003 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432857600000",
    "number": "1396792776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 ELLSWORTH DR",
            "city": "WARREN",
            "state": "NJ",
            "postal_code": "070597137",
            "telephone_number": "732-563-1155",
            "fax_number": "732-563-1156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 ELLSWORTH DR",
            "city": "WARREN",
            "state": "NJ",
            "postal_code": "070597137",
            "telephone_number": "732-563-1155",
            "fax_number": "732-563-1156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLUGER",
        "first_name": "LAWRENCE",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-30",
        "last_updated": "2015-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NJ",
            "license": "MA39126",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0990001",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, NJ

Sources for this page

Verify at the official NPI Registry.