Individual provider Active NPI

Samuel Lacapra, MD

  • Emergency Medicine Physician
  • Passaic, NJ
National Provider Identifier
1861431702
Registry record updated Jul 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MA60461 Issued in NJ
Practice address
350 Boulevard
Passaic, NJ 07055-2840
Phone
(973) 365-4489
Fax
(973) 916-2032
NPI assigned
Jun 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MA60461 NJ Primary

Addresses

Primary practice location

350 Boulevard
Passaic, NJ 07055-2840

Mailing address

307 S Evergreen Ave
Woodbury, NJ 08096-2739
Phone (856) 686-4300

Other identifiers 3

IdentifierTypeStateIssuer
223586664OtherNJTRICARE/CHAMPUS
2235886664OtherNJBCBS
6241301MedicaidNJ

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
I20040628001334 NJ Practitioner - Emergency Medicine 6305822511 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Rutgers R W Johnson Medical School (Cam/New Bruns/Pisc), 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Plainfield Emergency Physicians, PAGroup PAC ID 7719972728, 22 clinicians
Middlesex Emergency Physicians, P.a.Group PAC ID 9931002854, 41 clinicians

Practice addresses (Care Compare)

1200 Park Ave
Plainfield, NJ 07061
Phone (908) 668-2200

65 James St
Edison, NJ 08818-3903
Phone (732) 321-7000

Hospital & facility affiliations

  • JFK University Medical Center Hospital, Edison, NJ, CCN 310108

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA60461NJMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Plainfield Emergency Physicians, PA Emergency Medicine CurrentSince Jan 1, 2005 Accepting new patients
Middlesex Emergency Physicians, P.a. Emergency Medicine CurrentSince Feb 1, 2008 Accepting new patients
Emergency Physician Associates of North Jersey P C Emergency Medicine CurrentSince Aug 31, 2009 Accepting new patients

Locations

65 James St
Edison, NJ 08820
Phone (732) 321-7010

350 Boulevard
Passaic, NJ 07055
Phone (973) 365-4300

99 Beauvoir Ave
Summit, NJ 07901
Phone (908) 522-2232

307 S Evergreen Ave
Woodbury, NJ 08096
Phone (856) 686-4300

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690502400000",
    "number": "1861431702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 S EVERGREEN AVE",
            "city": "WOODBURY",
            "state": "NJ",
            "postal_code": "080962739",
            "telephone_number": "856-686-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 BOULEVARD",
            "city": "PASSAIC",
            "state": "NJ",
            "postal_code": "070552840",
            "telephone_number": "973-365-4489",
            "fax_number": "973-916-2032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACAPRA",
        "first_name": "SAMUEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2023-07-28",
        "certification_date": "2023-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "MA60461",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE/CHAMPUS",
            "identifier": "223586664",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "2235886664",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6241301",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Passaic, NJ

Sources for this page

Verify at the official NPI Registry.