Individual provider Active NPI

Elliot J. Lerner, M.D.

  • Neuroradiology Physician
  • Waldwick, NJ
National Provider Identifier
1639166598
Registry record updated Apr 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuroradiology PhysicianTaxonomy code 2085N0700X
License
25MA05576700 Issued in NJ
Practice address
20 Franklin Tpke
Waldwick, NJ 07463-1749
Phone
(201) 777-0705
Fax
(888) 275-3994
NPI assigned
Oct 5, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Neuroradiology Physician 2085N0700X ME180127 FL
Diagnostic Radiology Physician 2085R0202X ME180127 FL
Neuroradiology Physician 2085N0700X 25MA05576700 NJ Primary
Diagnostic Radiology Physician 2085R0202X 25MA05576700 NJ

Addresses

Primary practice location

20 Franklin Tpke
Waldwick, NJ 07463-1749

Mailing address

22 Mettowee Farms CT
Upper Saddle River, NJ 07458-2125
Phone (201) 777-0705

Other practice location 1

223 N Van Dien Ave
Ridgewood, NJ 07450-2726
Phone (201) 777-0705

Other identifiers 1

IdentifierTypeStateIssuer
5155801MedicaidNJ

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
I20050713000036 NJ Practitioner - Diagnostic Radiology 1759347388 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Warren Alpert Medical School of Brown University, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radiology Associates of Ridgewood P aGroup PAC ID 1254303332, 17 clinicians

Practice addresses (Care Compare)

20 Franklin Tpke
Waldwick, NJ 07463-1749
Phone (201) 445-8822

22 Mettowee Farms CT
Upper Saddle River, NJ 07458-2125
Phone (201) 447-8000

223 N Van Dien Ave
Ridgewood, NJ 07450-2726
Phone (201) 445-8822

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA05576700NJMDNeuroradiology Physician
ME180127FLMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Englewood Radiologic Group P a Diagnostic Radiology CurrentSince May 25, 2026 Accepting new patients
Radiology Associates of Ridgewood P a CurrentSince Aug 12, 1991 Accepting new patients

Locations

223 N Van Dien Ave
Ridgewood, NJ 07450
Phone (201) 447-8417

20 Franklin Tpke
Waldwick, NJ 07463
Phone (201) 445-3040

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1128470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776038400000",
    "number": "1639166598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 METTOWEE FARMS CT",
            "city": "UPPER SADDLE RIVER",
            "state": "NJ",
            "postal_code": "074582125",
            "telephone_number": "201-777-0705",
            "fax_number": "888-275-3994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 FRANKLIN TPKE",
            "city": "WALDWICK",
            "state": "NJ",
            "postal_code": "074631749",
            "telephone_number": "201-777-0705",
            "fax_number": "888-275-3994"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "223 N Van Dien Ave",
            "address_purpose": "LOCATION",
            "city": "Ridgewood",
            "state": "NJ",
            "postal_code": "074502726",
            "country_code": "US",
            "telephone_number": "201-777-0705",
            "fax_number": "888-275-3994",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LERNER",
        "first_name": "ELLIOT",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-05",
        "last_updated": "2026-04-13",
        "certification_date": "2026-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "FL",
            "license": "ME180127",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME180127",
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "NJ",
            "license": "25MA05576700",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NJ",
            "license": "25MA05576700",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5155801",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waldwick, NJ

Sources for this page

Verify at the official NPI Registry.