Active NPI
Lisa Melanie Ford, MD
- Neurology with Special Qualifications in Child Neurology Physician
- Newark, NJ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology with Special Qualifications in Child Neurology Physician
- License
- 25MA05696300
- Practice address
- 30 Bergen St
Admc 12 1205
Newark, NJ 07107-3000 - Phone
- (973) 972-9000
- NPI assigned
- Nov 20, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology with Special Qualifications in Child Neurology Physician | 2084N0402X | 25MA05696300 | NJ | Primary |
Addresses
Primary practice location
30 Bergen St
Admc 12 1205
Newark, NJ 07107-3000
Mailing address
30 Bergen St
Admc 12 1205
Newark, NJ 07107-3000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7328401 | Medicaid | NJ |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | lford11547@direct.uhnj.org | Direct | University Hospital |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160418001053 | NJ | Practitioner - Neurology | 8022316538 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA05696300 | NJ | MD | Neurology with Special Qualifications in Child Neurology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Physician Associates of New Jersey Inc | Neurology With Special Qualifications in Child Neurology | Current | Accepting new patients |
| University Physician Associates of New Jersey Inc | Current | Accepting new patients | |
| Pediatric Neurology Associates, P.a. | Neurology With Special Qualifications in Child Neurology | Past | Accepting new patients |
Locations
150 Bergen St
Newark, NJ 07103
Phone (973) 972-6056
90 Bergen St
#8100
Newark, NJ 07103
Phone (973) 972-2323
30 Bergen St
#12
Newark, NJ 07107
Phone (973) 972-0037
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.
-
- Neurology Physician
- Newark, NJ
- NPI 1902816507
Neurology With Special Qualifications in Child Neurology, NJ
-
- Internal Medicine Physician
- Newark, NJ
- NPI 1760492367
-
- Specialist
- Morristown, NJ
- NPI 1780770032
Neurology With Special Qualifications in Child Neurology
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643846400000",
"number": "1659445013",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 BERGEN ST",
"address_2": "ADMC 12 1205",
"city": "NEWARK",
"state": "NJ",
"postal_code": "071073000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 BERGEN ST",
"address_2": "ADMC 12 1205",
"city": "NEWARK",
"state": "NJ",
"postal_code": "071073000",
"telephone_number": "973-972-9000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORD",
"first_name": "LISA",
"middle_name": "MELANIE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-20",
"last_updated": "2022-02-03",
"certification_date": "2022-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0402X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
"state": "NJ",
"license": "25MA05696300",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7328401",
"state": "NJ"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "lford11547@direct.uhnj.org",
"affiliation": "Y",
"endpointDescription": "Epic",
"affiliationName": "University Hospital",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "150 Bergen St",
"city": "Newark",
"state": "NJ",
"country_code": "US",
"postal_code": "071032496",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
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- Jennifer Fong, DDS
- Mariah Jazze Fontanez-Lutsky, MD
- Foot & Ankle Center at St James
- Foot & Ankle Specialists of NJ LLC
- Nolleca Forbes, FNP, PMHNP
- Maegan Christine Ford, MD, MPH
- Forest Acupuncture & Herb Inc
- Forest Hill Family Health Associates P a
- Forest Hill Health Care Center, Inc.
- Forest Hill Physical Therapy LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2022; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.