NPIMap

Individual provider Active NPI

Vivian E Lan, MD

  • Internal Medicine Physician
  • Emerson, NJ
National Provider Identifier
1619912284
Registry record updated Jul 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MA65656 Issued in NJ
Practice address
466 Old Hook Rd
Suite #1
Emerson, NJ 07630-1396
Phone
(201) 967-8221
Fax
(201) 967-0340
NPI assigned
Jun 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2007

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 MA65656 NJ Primary

Addresses

Primary practice location

466 Old Hook Rd
Suite #1
Emerson, NJ 07630-1396

Mailing address

466 Old Hook Rd
Suite #1
Emerson, NJ 07630-1396
Phone (201) 967-8221

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050620000317 NJ Practitioner - Internal Medicine 8921042078 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Icahn School of Medicine at Mount Sinai, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
MPV New Jersey MD Services PCGroup PAC ID 5991097669, 146 clinicians

Practice addresses (Care Compare)

1 W Ridgewood Ave
Suite 211
Paramus, NJ 07652-2361
Phone (201) 251-2323

1 W Ridgewood Ave
Suite 301
Paramus, NJ 07652-2350
Phone (201) 445-1660

466 Old Hook Rd
Emerson, NJ 07630-1368

622 Franklin Ave
Nutley, NJ 07110-1247
Phone (973) 661-1900

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA65656NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MPV New Jersey MD Services PC CurrentSince Aug 1, 2017 Accepting new patients
Premier Medical Alliance LLC CurrentSince Mar 10, 2014 Accepting new patients
MPV New Jersey MD Services PC CurrentSince Aug 1, 2017 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

466 Old Hook Rd
Ste 1
Emerson, NJ 07630
Phone (201) 261-0821

1 W Ridgewood Ave
Ste 301
Paramus, NJ 07652
Phone (201) 444-7666

Interoperability endpoints

  • Direct secure messaging: vlan189878@ahs.direct-ci.com

Organizations & group practices 4

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.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184284800000",
    "number": "1619912284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "466 OLD HOOK RD",
            "address_2": "SUITE #1",
            "city": "EMERSON",
            "state": "NJ",
            "postal_code": "076301396",
            "telephone_number": "201-967-8221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "466 OLD HOOK RD",
            "address_2": "SUITE #1",
            "city": "EMERSON",
            "state": "NJ",
            "postal_code": "076301396",
            "telephone_number": "201-967-8221",
            "fax_number": "201-967-0340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAN",
        "first_name": "VIVIAN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-18",
        "last_updated": "2007-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "MA65656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Emerson, NJ

Sources for this page

Verify at the official NPI Registry.