Organization Active NPI

Lucila Medical PC

  • Specialist
  • Clifton, NJ
National Provider Identifier
1881978351
Registry record updated Oct 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
LUCILA MEDICAL PC
Practice address
780 Allwood Rd
Clifton, NJ 07012-1923
Phone
(973) 249-6202
Fax
(973) 249-6203
NPI assigned
Oct 3, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2011

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

Authorized official

Name
Dr. Rafael R V Lucila, M.D.
Title
Ceo
Phone
(973) 249-6202

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

780 Allwood Rd
Clifton, NJ 07012-1923

Mailing address

780 Allwood Rd
Clifton, NJ 07012-1923
Phone (973) 249-6202

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120221000081 NJ Part B Supplier - Clinic/Group Practice 7012175177 Receives reassigned benefits from 2 practitioners
Practice locations: Wayne, NJ; Paterson, NJ; Clifton, NJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1317600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317600000000",
    "number": "1881978351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "780 ALLWOOD RD",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070121923",
            "telephone_number": "973-249-6202",
            "fax_number": "973-249-6203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 ALLWOOD RD",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070121923",
            "telephone_number": "973-249-6202",
            "fax_number": "973-249-6203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUCILA MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-03",
        "last_updated": "2011-10-03",
        "status": "A",
        "authorized_official_last_name": "LUCILA",
        "authorized_official_first_name": "RAFAEL  R",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "973-249-6202",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.