Individual provider Active NPI

Lindasusan Marcus, MD

  • Dermatology Physician
  • Wyckoff, NJ
National Provider Identifier
1598875619
Registry record updated Aug 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
MA467830 Issued in NJ
Practice address
271 Godwin Ave
Wyckoff, NJ 07481
Phone
(201) 891-4373
Fax
(201) 891-0482
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X MA467830 NJ Primary

Addresses

Primary practice location

271 Godwin Ave
Wyckoff, NJ 07481

Mailing address

271 Godwin Ave
Wyckoff, NJ 07481
Phone (201) 891-4373

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
I20050316000751 NJ Practitioner - Dermatology 0547215139 Practice locations: Wyckoff, NJ

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
State University of New York Downstate Medical Center, 1975
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

271 Godwin Ave
Wyckoff, NJ 07481-2057
Phone (201) 891-4373

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision36
Removal of skin lesions388
Removal of nail tissue1-10
Removal or shaving of skin growth72
Skin biopsy72

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA467830NJMDDermatology Physician

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344643200000",
    "number": "1598875619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "271 GODWIN AVE",
            "city": "WYCKOFF",
            "state": "NJ",
            "postal_code": "07481",
            "telephone_number": "201-891-4373",
            "fax_number": "201-891-0482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "271 GODWIN AVE",
            "city": "WYCKOFF",
            "state": "NJ",
            "postal_code": "07481",
            "telephone_number": "201-891-4373",
            "fax_number": "201-891-0482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCUS",
        "first_name": "LINDASUSAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2012-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NJ",
            "license": "MA467830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyckoff, NJ

Sources for this page

Verify at the official NPI Registry.