Individual provider Active NPI

Lisa Perlmutter, ARNP

  • Pediatric Nurse Practitioner
  • West Caldwell, NJ
National Provider Identifier
1588933717
Registry record updated Feb 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
26NJ00603700 Issued in NJ
Practice address
616 Bloomfield Ave Ste 1a
West Caldwell, NJ 07006-7585
Phone
(973) 226-4439
NPI assigned
Dec 16, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X ARNP9332460 FL
Pediatric Nurse Practitioner 363LP0200X 26NJ00603700 NJ Primary

Addresses

Primary practice location

616 Bloomfield Ave Ste 1a
West Caldwell, NJ 07006-7585

Mailing address

616 Bloomfield Ave Ste 1a
West Caldwell, NJ 07006-7585
Phone (973) 226-4439

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
ARNP9332460FLMDPediatric Nurse Practitioner
26NJ00603700NJMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mariano D Cibran, MD Corp Dba St Petersburg Pediatrics Pediatrics Past Accepting new patients
Mariano D Cibran, MD Corp Dba St Petersburg Pediatrics PastSince Jun 22, 2021 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: lperlmutter76808@direct.optum.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1323993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612828800000",
    "number": "1588933717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "616 BLOOMFIELD AVE STE 1A",
            "city": "WEST CALDWELL",
            "state": "NJ",
            "postal_code": "070067585",
            "telephone_number": "973-226-4439",
            "fax_number": "973-226-4452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "616 BLOOMFIELD AVE STE 1A",
            "city": "WEST CALDWELL",
            "state": "NJ",
            "postal_code": "070067585",
            "telephone_number": "973-226-4439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERLMUTTER",
        "first_name": "LISA",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-16",
        "last_updated": "2021-02-09",
        "certification_date": "2021-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "ARNP9332460",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NJ",
            "license": "26NJ00603700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Caldwell, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.