Active NPI
Edgar Adrian Lugo Rodriguez, MD
- Child & Adolescent Psychiatry Physician
- Union, NJ
National Provider Identifier
1639668635
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatry Physician
- License
- 25MA12323100
- Practice address
- 2840 Morris Ave
Union, NJ 07083 - Phone
- (888) 244-5373
- NPI assigned
- May 4, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 25MA12323100 | NJ | |
| Child & Adolescent Psychiatry Physician | 2084P0804X | 25MA12323100 | NJ | Primary |
Addresses
Primary practice location
2840 Morris Ave
Union, NJ 07083
Mailing address
2840 Morris Ave
Union, NJ 07083-4851
Other practice location 1
4422 3rd Ave
Bronx, NY 10457-2594
Phone (718) 960-9000 ext. 6159
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Care Compare profile
Medicare Care Compare- Specialty
- Psychiatry
- Education
- Other, 2005
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
379 Campus Dr
Somerset, NJ 08873-1161
66 W Gilbert St
Tinton Falls, NJ 07701-4948
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA12323100 | NJ | MD | Child & Adolescent Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1525392000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731888000000",
"number": "1639668635",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2840 MORRIS AVE",
"city": "UNION",
"state": "NJ",
"postal_code": "070834851"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2840 MORRIS AVE",
"city": "UNION",
"state": "NJ",
"postal_code": "07083",
"telephone_number": "888-244-5373"
}
],
"practiceLocations": [
{
"address_1": "4422 3rd Ave",
"address_purpose": "LOCATION",
"city": "Bronx",
"state": "NY",
"postal_code": "104572594",
"country_code": "US",
"telephone_number": "718-960-9000 x6159",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LUGO RODRIGUEZ",
"first_name": "EDGAR",
"middle_name": "ADRIAN",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-05-04",
"last_updated": "2024-11-18",
"certification_date": "2024-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NJ",
"license": "25MA12323100",
"primary": false
},
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "NJ",
"license": "25MA12323100",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Union, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.