Individual provider Active NPI

Lutsiya S Pelimskaya, MD

  • Internal Medicine Physician
  • Delran, NJ
National Provider Identifier
1609886902
Registry record updated Dec 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA07628200 Issued in NJ
Practice address
8008 Route 130 Ste 120
Delran, NJ 08075-1869
Phone
(856) 764-1840
Fax
(856) 764-7997
NPI assigned
Aug 9, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MA07628200 NJ Primary

Addresses

Primary practice location

8008 Route 130 Ste 120
Delran, NJ 08075-1869

Mailing address

8008 Route 130 Ste 120
Delran, NJ 08075-1869
Phone (856) 764-1840

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040304000821 NJ Practitioner - Internal Medicine 3072401876 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA07628200NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cooper Care Alliance, PC CurrentSince Sep 27, 2021 Accepting new patients
Jefferson University Physicians Internal Medicine Past Accepting new patients
Family Physicians at Burlington Past Accepting new patients

Locations

1 Cooper Plz
Camden, NJ 08103
Phone (856) 342-2425

1 Federal St
Ste SW200
Camden, NJ 08103
Phone (856) 356-4920

2339 Route 70 W
Ste 200
Cherry Hill, NJ 08002
Phone (856) 751-6464

950 S Chester Ave
Ste A10
Delran, NJ 08075
Phone (856) 764-2500

901 Route 168
Ste 210
Turnersville, NJ 08012
Phone (856) 227-1221

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": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577059200000",
    "number": "1609886902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8008 ROUTE 130 STE 120",
            "city": "DELRAN",
            "state": "NJ",
            "postal_code": "080751869",
            "telephone_number": "856-764-1840",
            "fax_number": "856-764-7997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8008 ROUTE 130 STE 120",
            "city": "DELRAN",
            "state": "NJ",
            "postal_code": "080751869",
            "telephone_number": "856-764-1840",
            "fax_number": "856-764-7997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELIMSKAYA",
        "first_name": "LUTSIYA",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-09",
        "last_updated": "2019-12-23",
        "certification_date": "2019-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA07628200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Delran, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.