Enrique D Chappilliquen Lucio, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

25MP00411000 Issued in NJ

Practice address

3916 Kennedy Blvd
Union City, NJ 07087-2608

Phone

(201) 624-1877

NPI assigned

Sep 29, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Mercy College, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advanced Garden State Cardiology LLCGroup PAC ID 3375675036, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Advanced Garden State Cardiology LLC

  • Cardiovascular Disease Physician
  • Jersey City, NJ
  • NPI 1639481583
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1475107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475107200000",
    "number": "1801345046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 NEWARK AVE",
            "address_2": "SUITE 307",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073061326",
            "telephone_number": "201-418-0048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3916 KENNEDY BLVD",
            "city": "UNION CITY",
            "state": "NJ",
            "postal_code": "070872608",
            "telephone_number": "201-624-1877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAPPILLIQUEN LUCIO",
        "first_name": "ENRIQUE",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-09-29",
        "last_updated": "2016-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00411000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ruth Castro
• Cataldo Cacace M D LLC
• Catholic Charities of the Archdiocese of Newark
• Pearl Cenon, MD
• Albert Chang
• Mohammad A Chaudhry, M.D.
• Jenny Chavez, DDS
• Giri Chelian, DDS
• Children's Dental Care
• Children's Dental Center, PA

• Physician Assistant in Union City, NJ
• Providers in Union City, NJ by specialty
• Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.