Individual provider Active NPI

Marvin M Lipman, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Scarsdale, NY
National Provider Identifier
1790785178
Registry record updated Aug 31, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
77180 Issued in NY
Practice address
259 Heathcote Rd
Scarsdale, NY 10583-4523
Phone
(914) 723-8100
NPI assigned
Jul 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 77180 NY Primary

Addresses

Primary practice location

259 Heathcote Rd
Scarsdale, NY 10583-4523

Mailing address

259 Heathcote Rd
Scarsdale, NY 10583-4523
Phone (914) 723-8100

Other identifiers 1

IdentifierTypeStateIssuer
00563300MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20101101000107 NY Practitioner - Internal MedicinePractitioner - Endocrinology 9830290964

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
077180NYMDClinical Social Worker
77180NYMDEndocrinology, Diabetes & Metabolism Physician

NPI Registry JSON

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283212800000",
    "number": "1790785178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "259 HEATHCOTE RD",
            "city": "SCARSDALE",
            "state": "NY",
            "postal_code": "105834523",
            "telephone_number": "914-723-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "259 HEATHCOTE RD",
            "city": "SCARSDALE",
            "state": "NY",
            "postal_code": "105834523",
            "telephone_number": "914-723-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIPMAN",
        "first_name": "MARVIN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-28",
        "last_updated": "2010-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NY",
            "license": "77180",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00563300",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scarsdale, NY

Sources for this page

Verify at the official NPI Registry.