Organization Active NPI

New Jersey Family Medical

  • Family Medicine Physician
  • Cranford, NJ
National Provider Identifier
1477845055
Registry record updated Apr 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MB08803900 Issued in NJ
Legal business name
NEW JERSEY FAMILY MEDICAL
Practice address
27 South Ave W
Cranford, NJ 07016-2660
Phone
(908) 275-3810
Fax
(908) 275-8825
NPI assigned
May 13, 2011
Last updated
Apr 18, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2024

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

Authorized official

Name
Dr. Robert Lukenda, D.O.NPI 1144470600
Title
Owner
Phone
(908) 275-3810

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
Family Medicine Physician 207Q00000X 25MB08803900 NJ Primary

Addresses

Primary practice location

27 South Ave W
Cranford, NJ 07016-2660

Mailing address

27 South Ave W
Cranford, NJ 07016-2660
Phone (908) 275-3810

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110520000690 NJ Part B Supplier - Clinic/Group Practice 9537345806 Receives reassigned benefits from 6 practitioners
Practice locations: Cranford, NJ

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
31D2025433New Jersey Family Medical27 South Ave West, Cranford, NJ 07016Certificate of waiverJun 8, 2027

National Provider Directory

National Provider Directory

Locations

216 North Ave E
Cranford, NJ 07016
Phone (908) 272-7500

Practitioners & affiliated clinicians

Practitioners 21

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.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1305244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713398400000",
    "number": "1477845055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 SOUTH AVE W",
            "city": "CRANFORD",
            "state": "NJ",
            "postal_code": "070162660",
            "telephone_number": "908-275-3810",
            "fax_number": "908-275-8825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 SOUTH AVE W",
            "city": "CRANFORD",
            "state": "NJ",
            "postal_code": "070162660",
            "telephone_number": "908-275-3810",
            "fax_number": "908-275-8825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW JERSEY FAMILY MEDICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-13",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "status": "A",
        "authorized_official_last_name": "LUKENDA",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "908-275-3810",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MB08803900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cranford, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.