Individual provider Active NPI

Jeffrey L. Lautin, MD

  • Vascular & Interventional Radiology Physician
  • West Orange, NJ
National Provider Identifier
1689629875
Registry record updated Jan 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
25MA07034700 Issued in NJ
Practice address
741 Northfield Ave
Suite 105
West Orange, NJ 07052-1174
Phone
(973) 243-9729
Fax
(973) 243-9674
NPI assigned
May 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 1764691 NY
Vascular & Interventional Radiology Physician 2085R0204X 1764691 NY
Vascular & Interventional Radiology Physician 2085R0204X 25MA07034700 NJ Primary

Addresses

Primary practice location

741 Northfield Ave
Suite 105
West Orange, NJ 07052-1174

Mailing address

4000 Route 66
Suite 131
Tinton Falls, NJ 07753-7300
Phone (732) 383-4189

Other identifiers 1

IdentifierTypeStateIssuer
8163901MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050722000019 NJ Practitioner - Interventional RadiologyPractitioner - Diagnostic Radiology 1254233810 Reassigns benefits to 4 organizations
Practice locations: West Orange, NJ
I20101119000341 NY Practitioner - Diagnostic Radiology 1254233810 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Columbia University College of Physicians and Surgeons, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fpa Hospital BasedGroup PAC ID 4789826694, 423 clinicians

Practice addresses (Care Compare)

1 Gustave L Levy PL
New York, NY 10029-6504
Phone (212) 241-6426

5 Cuba Hill Rd
Greenlawn, NY 11740-1624
Phone (631) 628-5000

Hospital & facility affiliations

  • Mount Sinai Hospital Hospital, New York, NY, CCN 330024
  • Mount Sinai West Hospital, New York, NY, CCN 330046

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1764691NYMDDiagnostic Radiology Physician
25MA07034700NJMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Physician Services PC CurrentSince Dec 1, 2016 Accepting new patients
Robert Wood Johnson Medical Associates CurrentSince Jan 1, 2023 Accepting new patients
Icahn School of Medicine at Mount Sinai Diagnostic Radiology CurrentSince Aug 30, 2025 Accepting new patients
Rwjbh Observation Associates LLC Diagnostic Radiology CurrentSince Jan 1, 2023 Accepting new patients
Fpa Hospital Based CurrentSince Mar 1, 2023 Accepting new patients
North Shore Medical Group of the Mount Sinai School of Medicine Diagnostic Radiology CurrentSince Apr 12, 2025 Accepting new patients
North Shore Medical Group of the Mount Sinai School of Medicine CurrentSince Apr 12, 2025 Accepting new patients
Mount Sinai School of Medicine of New York University CurrentSince Jan 12, 2026 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Aug 30, 2025 Accepting new patients
Fpa Hospital Based Current Accepting new patients
Fpa Hospital Based CurrentSince Mar 1, 2023 Accepting new patients
Empire State Radiology P C Diagnostic Radiology CurrentSince Feb 5, 2023 Accepting new patients
Madison Avenue Radiology PC Diagnostic Radiology Past Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients
NJ Vein & Cosmetic Surgery Center, PA PastSince Jan 1, 1999 Accepting new patients
Newark Diagnostic Radiologists, PA PastSince Apr 25, 2005 Accepting new patients
Innovative Medical Diagnostic Care, PC Past Accepting new patients
Montefiore Medical Center Diagnostic Radiology Past Accepting new patients

Locations

1 Rwj Pl
New Brunswick, NJ 08901
Phone (732) 235-7887

201 Lyons Ave
#B2
Newark, NJ 07112
Phone (973) 926-7960

201 Lyons Ave
Newark, NJ 07112
Phone (732) 923-7455

1 Valley Health Plz
Paramus, NJ 07652
Phone (201) 634-5353

865 Stone St
Rahway, NJ 07065
Phone (732) 381-4000

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

110 Rehill Ave
Somerville, NJ 08876
Phone (908) 429-5833

1 Hamilton Health Pl
Trenton, NJ 08690
Phone (609) 584-6763

5 Cuba Hill Rd
Greenlawn, NY 11740
Phone (631) 628-5000

325 Park Ave
Huntington, NY 11743
Phone (631) 351-3700

3712 82nd St
Jackson Hts, NY 11372
Phone (718) 879-1600

1176 5th Ave
New York, NY 10029
Phone (212) 241-6237

1470 Madison Ave
New York, NY 10029
Phone (212) 241-0806

17E E 102nd St
#6D
New York, NY 10029
Phone (212) 241-6381

9901 Queens Blvd
Rego Park, NY 11374
Phone (718) 268-4500

1000 N Village Ave
Rockville Ctr, NY 11570
Phone (516) 705-1012

1000 N Village Ave
#13202
Rockville Ctr, NY 11570

341 Central Park Ave
Scarsdale, NY 10583
Phone (718) 676-5309

11 Ralph Pl
Ste 201
Staten Island, NY 10304
Phone (718) 556-6565

1441 South Ave
Staten Island, NY 10314
Phone (332) 243-6900

1086 N Broadway
Yonkers, NY 10701
Phone (914) 771-9666

12554 Riata Vista Cir
Austin, TX 78727
Phone (512) 519-3462

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: jlaut00@accessctr.md.direct-ci.com

Organizations & group practices 19

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.

View all 19

Hospital & facility affiliations 8

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": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674691200000",
    "number": "1689629875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 ROUTE 66",
            "address_2": "SUITE 131",
            "city": "TINTON FALLS",
            "state": "NJ",
            "postal_code": "077537300",
            "telephone_number": "732-383-4189",
            "fax_number": "732-383-4171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "741 NORTHFIELD AVE",
            "address_2": "SUITE 105",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070521174",
            "telephone_number": "973-243-9729",
            "fax_number": "973-243-9674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAUTIN",
        "first_name": "JEFFREY",
        "middle_name": "L.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-24",
        "last_updated": "2023-01-26",
        "certification_date": "2023-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "1764691",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NY",
            "license": "1764691",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NJ",
            "license": "25MA07034700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8163901",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Orange, NJ

Sources for this page

Verify at the official NPI Registry.