Individual provider Active NPI

Javier Jerry Lugo, M.D.

  • Pediatric Adolescent Medicine Physician
  • Pompton Plains, NJ
National Provider Identifier
1508940057
Registry record updated Jul 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
25MA05968700 Issued in NJ
Practice address
97 W Parkway
Pompton Plains, NJ 07444-1647
Phone
(973) 831-5120
Fax
(973) 831-5342
NPI assigned
Oct 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X 25MA05968700 NJ Primary

Addresses

Primary practice location

97 W Parkway
Pompton Plains, NJ 07444-1647

Mailing address

17 Woodlands Ave
White Plains, NY 10607-2807
Phone (914) 231-5273

Other identifiers 1

IdentifierTypeStateIssuer
6845509MedicaidNJ

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
I20170714002025 NJ Practitioner - Pediatric Medicine 2062657216 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physician Associates of North Jersey P C CurrentSince Jun 1, 2017 Accepting new patients
Ahs Hospital Corp. Past Accepting new patients
Chilton in Hospital Based Physicians LLC PastSince Jan 1, 2013 Accepting new patients

Locations

97 W Parkway
Pompton Plns, NJ 07444
Phone (973) 831-5000

99 Beauvoir Ave
Summit, NJ 07901
Phone (908) 522-2232

Interoperability endpoints

  • Direct secure messaging: javier.lugo@pediatricareassociates.chartmakerdirect.com

Organizations & group practices 3

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": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752624000000",
    "number": "1508940057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 WOODLANDS AVE",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106072807",
            "telephone_number": "914-231-5273",
            "fax_number": "914-674-2408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "97 W PARKWAY",
            "city": "POMPTON PLAINS",
            "state": "NJ",
            "postal_code": "074441647",
            "telephone_number": "973-831-5120",
            "fax_number": "973-831-5342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUGO",
        "first_name": "JAVIER",
        "middle_name": "JERRY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "NJ",
            "license": "25MA05968700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6845509",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pompton Plains, NJ

Sources for this page

Verify at the official NPI Registry.