Lifeline Primary Care LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

25MA09556300 Issued in NJ

Legal business name

LIFELINE PRIMARY CARE LLC

Practice address

662 Commons Way BLDG I4
Toms River, NJ 08755-6431

Phone

(732) 279-3681

Fax

(732) 279-6043

NPI assigned

Apr 11, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Palakkumar Patel, M.D.NPI 1053559427

Title

Owner

Phone

(908) 328-8491

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Palakkumar Kantilal Patel, M.D.

  • Internal Medicine Physician
  • Toms River, NJ
  • NPI 1053559427
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1460332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1770947145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "662 COMMONS WAY BLDG I4",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087556431",
            "telephone_number": "732-279-3681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "662 COMMONS WAY BLDG I4",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087556431",
            "telephone_number": "732-279-3681",
            "fax_number": "732-279-6043"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "780 Route 37 W Ste 220",
            "address_purpose": "LOCATION",
            "city": "Toms River",
            "state": "NJ",
            "postal_code": "087555059",
            "country_code": "US",
            "telephone_number": "732-279-3681",
            "fax_number": "732-279-6043",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LIFELINE PRIMARY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-11",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "PALAKKUMAR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "908-328-8491",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NJ",
            "license": "25MA09556300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Christine B Lill, MSW
• Richard C Lill II, LCSW
• Christopher Thomas Lillo, D.M.D.

• Primary Care Clinic/Center in Toms River, NJ
• Providers in Toms River, NJ by specialty
• Primary Care Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.