Individual provider Active NPI

Liju Philip, M.D.

  • Emergency Medicine Physician
  • New Hyde Park, NY
National Provider Identifier
1891085742
Registry record updated Aug 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
263988 Issued in NY
Practice address
27005 76TH Ave
New Hyde Park, NY 11040-1402
Phone
(718) 347-7849
NPI assigned
Apr 12, 2011
Last updated
Aug 16, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 25MA10012600 NJ
Emergency Medicine Physician 207P00000X 263988 NY Primary

Addresses

Primary practice location

27005 76TH Ave
New Hyde Park, NY 11040-1402

Mailing address

1825 Eastchester Rd
Bronx, NY 10461-2301
Phone (845) 642-6205

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150207000353 NY Practitioner - Emergency Medicine 3476878745 Reassigns benefits to 4 organizations
I20170421001764 NJ Practitioner - Emergency Medicine 3476878745 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
State University of New York Downstate Medical Center, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Physician Associates of North Jersey P CGroup PAC ID 7911992326, 125 clinicians
Barron Emergency Physicians LLCGroup PAC ID 8820083785, 99 clinicians

Practice addresses (Care Compare)

727 N Beers St
Holmdel, NJ 07733-1514
Phone (732) 739-5900

7600 River Rd
North Bergen, NJ 07047-6217
Phone (954) 939-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
263988NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center Emergency Medicine CurrentSince Jul 11, 2014 Accepting new patients
Nyack Emergency Medical Association PLLC Emergency Medicine CurrentSince Apr 18, 2017 Accepting new patients
Montefiore Medical Center CurrentSince Jul 11, 2014 Accepting new patients
Brunswick Urgent Care P a Emergency Medicine CurrentSince Jun 1, 2021 Accepting new patients
Emergency Physician Associates of North Jersey P C Emergency Medicine CurrentSince Mar 26, 2024 Accepting new patients
Emergency Medical Association Sound Shore PLLC Emergency Medicine CurrentSince Jun 1, 2016 Accepting new patients
Rwjbh Observation Associates LLC Emergency Medicine CurrentSince Jun 20, 2024 Accepting new patients
Rwjbh Emergency Medicine Associates, LLC Emergency Medicine CurrentSince Oct 4, 2022 Accepting new patients
Emergency Medical Association of New York PC Emergency Medicine CurrentSince May 1, 2017 Accepting new patients
Montefiore Mount Vernon Hospital Past Accepting new patients

Locations

641 Route 18
East Brunswick, NJ 08816
Phone (732) 422-4889

300 Central Ave
East Orange, NJ 07018
Phone (973) 266-8460

225 Williamson St
Elizabeth, NJ 07202
Phone (908) 994-5204

3185 State Route 27
Franklin Park, NJ 08823
Phone (732) 422-4889

727 N Beers St
Holmdel, NJ 07733
Phone (732) 714-2700

355 Grand St
Jersey City, NJ 07302
Phone (201) 915-2224

600 River Ave
Lakewood, NJ 08701
Phone (732) 363-1900

1 Riverview Plz
Red Bank, NJ 07701
Phone (732) 530-2204

110 Rehill Ave
Somerville, NJ 08876
Phone (908) 429-5833

1140 Route 72 W
Stafford Township, NJ 08050
Phone (609) 978-2194

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

99 State Route 37 W
Toms River, NJ 08755
Phone (732) 240-8000

1 Hamilton Health Pl
Trenton, NJ 08690
Phone (609) 584-6763

111 E 210th St
Bronx, NY 10467

1825 Eastchester Rd
Bronx, NY 10461
Phone (718) 904-2000

1980 Crompond Rd
Cortlandt Mnr, NY 10567
Phone (914) 734-3600

16 Guion Pl
New Rochelle, NY 10801
Phone (914) 365-3680

160 N Midland Ave
Nyack, NY 10960
Phone (845) 348-2000

Interoperability endpoints

  • Direct secure messaging: lphilip450346@ahs.direct-ci.com

Organizations & group practices 11

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.

Hospital & facility affiliations 5

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": "1302566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723766400000",
    "number": "1891085742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1825 EASTCHESTER RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104612301",
            "telephone_number": "845-642-6205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27005 76TH AVE",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110401402",
            "telephone_number": "718-347-7849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILIP",
        "first_name": "LIJU",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-12",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "25MA10012600",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "263988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hyde Park, NY

Sources for this page

Verify at the official NPI Registry.