Individual provider Active NPI

Jay Howard Lippman, M.D.

  • Internal Medicine Physician
  • Jersey City, NJ
National Provider Identifier
1750378089
Registry record updated May 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D25001 Issued in MD
Practice address
355 Grand St
Jersey City, NJ 07302-4321
Phone
(201) 915-2000
NPI assigned
Oct 3, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D25001 MD Primary

Addresses

Primary practice location

355 Grand St
Jersey City, NJ 07302-4321

Mailing address

77 Hudson St
# 3711
Jersey City, NJ 07302-8517
Phone (410) 292-9652

Other identifiers 1

IdentifierTypeStateIssuer
329081600MedicaidMD

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140905001936 NJ Practitioner - Hospice/Palliative Care 0648324566 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D25001MDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Barnabas Health Medical Group PC Internal Medicine CurrentSince Aug 15, 2015 Accepting new patients
Barnabas Health Medical Group PC CurrentSince Aug 15, 2015 Accepting new patients
Tri-County Home and Hospice Care,LLC PastSince Oct 26, 2015 Accepting new patients

Locations

355 Grand St
Jersey City, NJ 07302
Phone (201) 915-2224

475 Route 70
Ste 101
Lakewood, NJ 08701
Phone (732) 364-8000

94 Old Short Hills Rd
Livingston, NJ 07039
Phone (973) 322-5400

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.

NPI Registry JSON

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

{
    "created_epoch": "1128297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401148800000",
    "number": "1750378089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 HUDSON ST",
            "address_2": "# 3711",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073028517",
            "telephone_number": "410-292-9652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 GRAND ST",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073024321",
            "telephone_number": "201-915-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIPPMAN",
        "first_name": "JAY",
        "middle_name": "HOWARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-03",
        "last_updated": "2014-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D25001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "329081600",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jersey City, NJ

Sources for this page

Verify at the official NPI Registry.