Organization Active NPI

South Jersey Infectious Disease

  • Infectious Disease Physician
  • Somers Point, NJ
National Provider Identifier
1699720425
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
Legal business name
SOUTH JERSEY INFECTIOUS DISEASE
Practice address
730 Shore Rd
Somers Point, NJ 08244-2331
Phone
(609) 927-6662
Fax
(609) 927-2942
NPI assigned
May 23, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Christopher J Lucasti, D.O.NPI 1467447417
Title
President
Phone
(609) 927-6662

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X NJ Primary

Addresses

Primary practice location

730 Shore Rd
Somers Point, NJ 08244-2331

Mailing address

730 Shore Rd
Somers Point, NJ 08244-2331
Phone (609) 927-6662

Other identifiers 1

IdentifierTypeStateIssuer
6283306MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041201000097 NJ Part B Supplier - Clinic/Group Practice 3375508476 Receives reassigned benefits from 6 practitioners
Practice locations: Millville, NJ; Somers Point, NJ

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
31D2038481South Jersey Infectious Disease730 Shore Road, Somers Point, NJ 08244Certificate of waiverMar 20, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1699720425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 SHORE RD",
            "city": "SOMERS POINT",
            "state": "NJ",
            "postal_code": "082442331",
            "telephone_number": "609-927-6662",
            "fax_number": "609-927-2942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 SHORE RD",
            "city": "SOMERS POINT",
            "state": "NJ",
            "postal_code": "082442331",
            "telephone_number": "609-927-6662",
            "fax_number": "609-927-2942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH JERSEY INFECTIOUS DISEASE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LUCASTI",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "609-927-6662",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6283306",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Somers Point, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.