Individual provider Active NPI

Elliot A Lipstock, MD

  • Internal Medicine Physician
  • Fairhaven, MA
National Provider Identifier
1962462028
Registry record updated Jan 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
36832 Issued in MA
Practice address
276 Alden Rd
Fairhaven, MA 02719-4430
Phone
(508) 997-6763
Fax
(508) 999-5735
NPI assigned
Mar 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 36832 MA Primary

Addresses

Primary practice location

276 Alden Rd
Fairhaven, MA 02719-4430

Mailing address

276 Alden Rd
Fairhaven, MA 02719-4430
Phone (508) 997-6763

Other identifiers 1

IdentifierTypeStateIssuer
2045311MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20071207000034 MA Practitioner - Internal Medicine 6608813464 Practice locations: Mattapoisett, MA

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
New Bedford Medical Associates PC Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294185600000",
    "number": "1962462028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "276 ALDEN RD",
            "city": "FAIRHAVEN",
            "state": "MA",
            "postal_code": "027194430",
            "telephone_number": "508-997-6763",
            "fax_number": "508-999-5735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "276 ALDEN RD",
            "city": "FAIRHAVEN",
            "state": "MA",
            "postal_code": "027194430",
            "telephone_number": "508-997-6763",
            "fax_number": "508-999-5735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIPSTOCK",
        "first_name": "ELLIOT",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2011-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "36832",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2045311",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairhaven, MA

Sources for this page

Verify at the official NPI Registry.