Individual provider Active NPI

Steve Lequerica, MD

  • Neurology Physician
  • Clifton, NJ
National Provider Identifier
1881689495
Registry record updated Jun 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
25MA04606800 Issued in NJ
Practice address
905 Allwood Rd
Suite 105
Clifton, NJ 07012-1945
Phone
(973) 471-3680
Fax
(973) 471-6360
NPI assigned
Sep 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 25MA04606800 NJ Primary

Addresses

Primary practice location

905 Allwood Rd
Suite 105
Clifton, NJ 07012-1945

Mailing address

905 Allwood Rd
Suite 105
Clifton, NJ 07012-1945
Phone (973) 471-3680

Other identifiers 8

IdentifierTypeStateIssuer
0100004850OtherNJAMERICHOICE
0357901MedicaidNJ
4516374OtherAETNA
OK1390OtherHEALTHNET
130005561OtherRAILROAD MEDICARE
10780OtherNJAMERIGROUP
1340273OtherNJUNITED HEALTHCARE
PS225OtherOXFORD

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
I20040804000381 NJ Practitioner - Neurology 5597736462 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Boston University School of Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Summit Medical Group PAGroup PAC ID 5395642276, 1,204 clinicians

Practice addresses (Care Compare)

1 Diamond Hill Rd
Berkeley Heights, NJ 07922-2104
Phone (908) 273-4300

Hospital & facility affiliations

  • St Joseph'S University Medical Center Inc Hospital, Paterson, NJ, CCN 310019
  • Kessler Rehab Center Inpatient rehabilitation facility, West Orange, NJ, CCN 313025

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group PA CurrentSince Jul 31, 2017 Accepting new patients
Summit Medical Group PA CurrentSince Jul 31, 2017 Accepting new patients
Summit Medical Group, Inc Past Accepting new patients

Locations

148 State St
Fl 10
Boston, MA 02109
Phone (617) 426-2026

1 Diamond Hill Rd
Berkeley Heights, NJ 07922
Phone (908) 277-8868

Interoperability endpoints

  • Direct secure messaging: steve.lequerica.1@2983.direct.athenahealth.com

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": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340668800000",
    "number": "1881689495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 ALLWOOD RD",
            "address_2": "SUITE 105",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070121945",
            "telephone_number": "973-471-3680",
            "fax_number": "973-471-6360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 ALLWOOD RD",
            "address_2": "SUITE 105",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070121945",
            "telephone_number": "973-471-3680",
            "fax_number": "973-471-6360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEQUERICA",
        "first_name": "STEVE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-20",
        "last_updated": "2012-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NJ",
            "license": "25MA04606800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICHOICE",
            "identifier": "0100004850",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0357901",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4516374",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "OK1390",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "130005561",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "10780",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1340273",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "PS225",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton, NJ

Sources for this page

Verify at the official NPI Registry.