Individual provider Active NPI

Adam Halladay Lackey, M.D.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Royal Oak, MI
National Provider Identifier
1922145291
Registry record updated May 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
25MA10411900 Issued in NJ
Practice address
3577 W 13 Mile Rd
Suite 402
Royal Oak, MI 48073-6710
Phone
(248) 551-9910
Fax
(248) 551-9912
NPI assigned
Jan 30, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 25MA10411900 NJ
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 257557 NY
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 25MA10411900 NJ Primary

Addresses

Primary practice location

3577 W 13 Mile Rd
Suite 402
Royal Oak, MI 48073-6710

Mailing address

3 Executive Dr Ste 400
Somerset, NJ 08873-4007
Phone (732) 369-5994

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
I20200806001153 NJ Practitioner - Thoracic Surgery 4880828615 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Thoracic Surgery
Education
University of Virginia School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Barnabas Health Medical Group PCGroup PAC ID 9537316955, 1,027 clinicians

Practice addresses (Care Compare)

1 Clara Maass Dr
Belleville, NJ 07109-3550
Phone (973) 450-2616

201 Lyons Ave
Newark, NJ 07112-2027

355 Grand St
Jersey City, NJ 07302-4321
Phone (201) 915-2000

414 Grand St
Jersey City, NJ 07302-4240

519 Broadway
Bayonne, NJ 07002-3713

94 Old Short Hills Rd
Livingston, NJ 07039-5672

Hospital & facility affiliations

  • Jersey City Medical Center Hospital, Jersey City, NJ, CCN 310074
  • Cooperman Barnabas Medical Center Hospital, Livingston, NJ, CCN 310076
  • Clara Maass Medical Center Hospital, Belleville, NJ, CCN 310009
  • Newark Beth Israel Medical Center Hospital, Newark, NJ, CCN 310002

Merit-based Incentive Payment System (MIPS)

Final score
98.51 of 100Reported as apm
Quality
84.27
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA10411900NJMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
257557NYMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Barnabas Health Medical Group PC Surgery CurrentSince Aug 1, 2020 Accepting new patients
Barnabas Health Medical Group PC CurrentSince Aug 1, 2020 Accepting new patients

Locations

519 Broadway
Ste 3600
Bayonne, NJ 07002
Phone (551) 214-3540

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

475 Route 70
Ste 101
Lakewood, NJ 08701
Phone (732) 364-8000

94 Old Short Hills Rd
Livingston, NJ 07039
Phone (973) 322-5400

3 Executive Dr
Ste 400
Somerset, NJ 08873
Phone (732) 369-5949

101 Old Short Hills Rd
Ste 302
West Orange, NJ 07052
Phone (973) 322-6200

Interoperability endpoints

  • Direct secure messaging: alackey46007@epicdirect.rwjbh.org

Organizations & group practices 2

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 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": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714521600000",
    "number": "1922145291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 EXECUTIVE DR STE 400",
            "city": "SOMERSET",
            "state": "NJ",
            "postal_code": "088734007",
            "telephone_number": "732-369-5994",
            "fax_number": "732-369-5993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3577 W 13 MILE RD",
            "address_2": "SUITE 402",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480736710",
            "telephone_number": "248-551-9910",
            "fax_number": "248-551-9912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACKEY",
        "first_name": "ADAM",
        "middle_name": "HALLADAY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2024-05-01",
        "certification_date": "2024-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NJ",
            "license": "25MA10411900",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "NY",
            "license": "257557",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "NJ",
            "license": "25MA10411900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Royal Oak, MI

Sources for this page

Verify at the official NPI Registry.