Individual provider Active NPI

Mercedes Lesesne, M.D.

  • Pediatric Adolescent Medicine Physician
  • Paterson, NJ
National Provider Identifier
1811938293
Registry record updated Mar 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
MA36371 Issued in NJ
Practice address
625 Broadway
1St Floor
Paterson, NJ 07514-1917
Phone
(973) 523-1102
Fax
(973) 523-7309
NPI assigned
Jun 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X MA36371 NJ Primary

Addresses

Primary practice location

625 Broadway
1St Floor
Paterson, NJ 07514-1917

Mailing address

625 Broadway
1St Floor
Paterson, NJ 07514-1917
Phone (973) 523-1102

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MA36371NJMDPediatric Adolescent Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Josephs University Medical Center Inc. Past Accepting new patients
Eastside Pediatrics LLC Past Accepting new patients
Barnert FCC Housemeds Group Past Accepting new patients

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": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364169600000",
    "number": "1811938293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 BROADWAY",
            "address_2": "1ST FLOOR",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075141917",
            "telephone_number": "973-523-1102",
            "fax_number": "973-523-7309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 BROADWAY",
            "address_2": "1ST FLOOR",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075141917",
            "telephone_number": "973-523-1102",
            "fax_number": "973-523-7309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LESESNE",
        "first_name": "MERCEDES",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-09",
        "last_updated": "2013-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "NJ",
            "license": "MA36371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paterson, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2013; 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.