Active NPI
Mark H Lipman, OD
- Optometrist
- Camden, NJ
National Provider Identifier
1720140387
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 27T000039100
- Practice address
- 400 Chambers Ave
Camden, NJ 08103 - Phone
- (856) 616-9500
- Fax
- (856) 616-9259
- NPI assigned
- Dec 13, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | 27T000039100 | NJ | Primary |
Addresses
Primary practice location
400 Chambers Ave
Camden, NJ 08103
Mailing address
400 Chambers Ave
Camden, NJ 08103
Phone (856) 616-9500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2460700 | Medicaid | NJ |
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: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040302000312 | NJ | Practitioner - Optometry | 9537056817 | Practice locations: Voorhees, NJ |
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Pennsylvania College of Optometry, 1980
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1 Britton PL
Suite 9
Voorhees, NJ 08043-2514
Phone (856) 772-1444
1 Britton Place
Suite 9
Voorhees, NJ 08043-2514
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4029 | NJ | MD | Psychologist |
| 27T000039100 | NJ | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165968000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1346198400000",
"number": "1720140387",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 CHAMBERS AVE",
"city": "CAMDEN",
"state": "NJ",
"postal_code": "08103",
"telephone_number": "856-616-9500",
"fax_number": "856-616-9259"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 CHAMBERS AVE",
"city": "CAMDEN",
"state": "NJ",
"postal_code": "08103",
"telephone_number": "856-616-9500",
"fax_number": "856-616-9259"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIPMAN",
"first_name": "MARK",
"middle_name": "H",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-13",
"last_updated": "2012-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NJ",
"license": "27T000039100",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2460700",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Camden, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2012; 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.