Individual provider Active NPI

Lisa Anne Mason, NP

  • Family Nurse Practitioner
  • Freehold, NJ
National Provider Identifier
1619922754
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26N007222900 Issued in NJ
Practice address
901 W Main Street
Centrastate Medical Center
Freehold, NJ 07728
Phone
(732) 294-2666
Fax
(732) 431-8267
NPI assigned
May 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 26N007222900 NJ Primary

Addresses

Primary practice location

901 W Main Street
Centrastate Medical Center
Freehold, NJ 07728

Mailing address

PO Box 2680
Central Jersey Emergency Medicine Associates PC
New Brunswick, NJ 08903-2680
Phone (800) 666-2455

Other identifiers 1

IdentifierTypeStateIssuer
8293201MedicaidNJ

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040713000400 NJ Practitioner - Nurse Practitioner 3173501384 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26N007222900NJMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Atlantic Professional Services of New Jersey, P.a. Past Accepting new patients
Kenneth Faistl, MD,PA PastSince Mar 13, 2009 Accepting new patients

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": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619922754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2680",
            "address_2": "CENTRAL JERSEY EMERGENCY MEDICINE ASSOCIATES PC",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089032680",
            "telephone_number": "800-666-2455",
            "fax_number": "610-617-6280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 W MAIN STREET",
            "address_2": "CENTRASTATE MEDICAL CENTER",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "07728",
            "telephone_number": "732-294-2666",
            "fax_number": "732-431-8267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASON",
        "first_name": "LISA",
        "middle_name": "ANNE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26N007222900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8293201",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Freehold, NJ

Sources for this page

Verify at the official NPI Registry.