Individual provider Active NPI

Edmar Manabat Lacay, M.D.

  • Sports Medicine (Family Medicine) Physician
  • Camden, NJ
National Provider Identifier
1821248907
Registry record updated Oct 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
25MA08985600 Issued in NJ
Practice address
3 Cooper PLZ
Suite 502
Camden, NJ 08103-1438
Phone
(856) 968-7433
Fax
(856) 968-8499
NPI assigned
Sep 24, 2008
Last updated
Oct 4, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 125053230 IL
Sports Medicine (Family Medicine) Physician 207QS0010X 25MA08985600 NJ Primary
Sports Medicine (Family Medicine) Physician 207QS0010X MD443555 PA

Addresses

Primary practice location

3 Cooper PLZ
Suite 502
Camden, NJ 08103-1438

Mailing address

1 Federal St
Ste Sw200
Camden, NJ 08103-1155
Phone (856) 968-7433

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111027000874 NJ Practitioner - Family PracticePractitioner - Orthopedic Surgery 2961675442 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
99.52 of 100Reported as apm
Quality
81.58
Promoting interoperability
99.4
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125053230ILMDFamily Medicine Physician
25MA08985600NJMDSports Medicine (Family Medicine) Physician
MD443555PAMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cooper Family Medicine PC Family Medicine CurrentSince Apr 1, 2021 Accepting new patients
Cooper Family Medicine, PC Family Medicine CurrentSince Apr 1, 2021 Accepting new patients
Inspira Medical Centers, Inc. Past Accepting new patients
Inspira Medical Centers, Inc. Past Accepting new patients
Inspira Medical Centers, Inc. Past Accepting new patients
The Cooper Health System Past Accepting new patients

Locations

1 Federal St
Ste SW200
Camden, NJ 08103
Phone (856) 356-4920

3 Cooper Plz
Rm 502
Camden, NJ 08103
Phone (856) 342-2921

504 White Horse Pike
Haddon Hgts, NJ 08035
Phone (856) 546-7990

1001 Lincoln Dr W
Ste F
Marlton, NJ 08053
Phone (609) 810-1800

390 N Broadway
Ste 100
Pennsville, NJ 08070
Phone (609) 678-6411

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1222214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475539200000",
    "number": "1821248907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FEDERAL ST",
            "address_2": "STE SW200",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031155",
            "telephone_number": "856-968-7433",
            "fax_number": "856-968-8499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 COOPER PLZ",
            "address_2": "SUITE 502",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031438",
            "telephone_number": "856-968-7433",
            "fax_number": "856-968-8499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACAY",
        "first_name": "EDMAR",
        "middle_name": "MANABAT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-24",
        "last_updated": "2016-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "125053230",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "NJ",
            "license": "25MA08985600",
            "primary": true
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "PA",
            "license": "MD443555",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camden, NJ

Sources for this page

Verify at the official NPI Registry.