Individual provider Active NPI

Lisa Solomon Pivawer, DO

  • Pediatrics Physician
  • West Orange, NJ
National Provider Identifier
1750509089
Registry record updated Jul 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
25MB08229500 Issued in NJ
Practice address
1500 Pleasant Valley Way
West Orange, NJ 07052-2956
Phone
(973) 243-0002
NPI assigned
Apr 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 25MB08229500 NJ Primary

Addresses

Primary practice location

1500 Pleasant Valley Way
West Orange, NJ 07052-2956

Mailing address

1500 Pleasant Valley Way
West Orange, NJ 07052-2956
Phone (973) 243-0002

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
I20200203000337 NJ Practitioner - Pediatric Medicine 5799111258 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MB08229500NJMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advocare, LLC Pediatrics CurrentSince Mar 1, 2020 Accepting new patients
Advocare , LLC CurrentSince Mar 1, 2020 Accepting new patients
Kintiroglou Pediatrics LLC Pediatrics Past Accepting new patients

Locations

169 Mine Brook Rd
#P
Bernardsville, NJ 07924
Phone (908) 766-0034

7 James St
Florham Park, NJ 07932
Phone (973) 295-6226

132 Grove St
Ste A
Haddonfield, NJ 08033
Phone (856) 354-2211

401 Route 73 N
Ste 320
Marlton, NJ 08053
Phone (609) 471-1033

745 Northfield Ave
Ste 7
West Orange, NJ 07052
Phone (973) 243-0002

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": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185753600000",
    "number": "1750509089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 PLEASANT VALLEY WAY",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070522956",
            "telephone_number": "973-243-0002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 PLEASANT VALLEY WAY",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070522956",
            "telephone_number": "973-243-0002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIVAWER",
        "first_name": "LISA",
        "middle_name": "SOLOMON",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-23",
        "last_updated": "2007-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MB08229500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Orange, NJ

Sources for this page

Verify at the official NPI Registry.