Lauren H Im-Imamura, D.O,

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

25MB10503700 Issued in NJ

Practice address

99 Beauvoir Ave
Summit, NJ 07901-3533

Phone

(908) 522-2000

NPI assigned

May 11, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Lauren Heeson Im Former name

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Family Practice

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Accentcare Home Health of Fort Worth Home health agency, Fort Worth, TX, CCN 747526
• Baylor Scott & White Medical Center Grapevine Hospital, Grapevine, TX, CCN 450563
• Baylor Institute for Rehabilitation at Fort Worth Inpatient rehabilitation facility, Fort Worth, TX, CCN 673035

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: limimamura1319843@direct.sw.org

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.

• Healthtexas Provider Network

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1760488936
  Medicare reassignment Care Compare group NPD
• Healthtexas Provider Network

  • Anesthesiology Physician
  • Lakeway, TX
  • NPI 1104714583
  NPD
• Healthtexas Provider Network

  • Family Medicine Physician
  • Colleyville, TX
  • NPI 1235135906
  NPD
• Healthtexas Provider Network

  • Family Medicine Physician
  • Plano, TX
  • NPI 1003811639
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Baylor Regional Medical Center at Grapevine

  • General Acute Care Hospital
  • Grapevine, TX
  • NPI 1073511762
  Care Compare affiliation
• Global Rehab Fort Worth, LP

  • Rehabilitation Hospital
  • Fort Worth, TX
  • NPI 1396902540

  Inpatient rehabilitation facility

  Care Compare affiliation
• Texas Home Health Group of Fort Worth, LLC

  • Home Health Agency
  • Fort Worth, TX
  • NPI 1023548930
  Care Compare affiliation

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

{
    "created_epoch": "1462924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594944000000",
    "number": "1003262783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 DIAMOND HILL RD",
            "city": "BERKELEY HEIGHTS",
            "state": "NJ",
            "postal_code": "079222104",
            "telephone_number": "908-977-9376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 BEAUVOIR AVE",
            "city": "SUMMIT",
            "state": "NJ",
            "postal_code": "079013533",
            "telephone_number": "908-522-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IM-IMAMURA",
        "first_name": "LAUREN",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "D.O,",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-11",
        "last_updated": "2020-07-17",
        "certification_date": "2020-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NJ",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MB10503700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAUREN",
            "last_name": "IM",
            "middle_name": "HEESON",
            "prefix": "DR.",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Olumuyiwa Adedotun Ibikunle, M.D
• Mounir R. Ibrahim
• Fathima Idris, DO
• Ilya Kupershtein MD PC
• Sahar Ilyas, MD
• Imaging Associates of New Jersey PC
• Karen Infantini
• Thomas Vincent Inglesby Sr., M.D.
• Inner Ventures
• Integrated Behavioral Care PA

• Family Medicine Physician in Summit, NJ
• Providers in Summit, NJ by specialty
• Family Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.