Individual provider Active NPI

Mark H Lipman, OD

  • Optometrist
  • Camden, NJ
National Provider Identifier
1720140387
Registry record updated Aug 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
27T000039100 Issued in NJ
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

Updated by the provider on Aug 29, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
2460700MedicaidNJ

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
4029NJMDPsychologist
27T000039100NJMDOptometrist

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

Verify at the official NPI Registry.