Individual provider Active NPI

Martin S Lipsky, MD

  • Family Medicine Physician
  • Rockford, IL
National Provider Identifier
1801870845
Registry record updated Sep 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Practice address
1221 E State St
University Family Health Center
Rockford, IL 61104-2231
Phone
(815) 972-1000
Fax
(815) 972-1033
NPI assigned
Dec 2, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X IL Primary

Addresses

Primary practice location

1221 E State St
University Family Health Center
Rockford, IL 61104-2231

Mailing address

1601 Parkview Ave
Credentialing S200
Rockford, IL 61107-1822
Phone (815) 395-5851

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036095260ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group Past Accepting new patients

Organizations & group practices 1

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": "1133481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189382400000",
    "number": "1801870845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 PARKVIEW AVE",
            "address_2": "CREDENTIALING S200",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611071822",
            "telephone_number": "815-395-5851",
            "fax_number": "815-395-5644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 E STATE ST",
            "address_2": "UNIVERSITY FAMILY HEALTH CENTER",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611042231",
            "telephone_number": "815-972-1000",
            "fax_number": "815-972-1033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIPSKY",
        "first_name": "MARTIN",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-02",
        "last_updated": "2007-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.