Active NPI
Lawrence J Tarasuk, DO
- Surgery Physician
- Southampton, NY
National Provider Identifier
1013182591
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 248412
- Practice address
- 325 Meeting House LN
BLDG 2 Suite 403
Southampton, NY 11968-5087 - Phone
- (631) 283-2100
- Fax
- (631) 283-5731
- NPI assigned
- Apr 25, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 248412 | NY | Primary |
| Hospitalist Physician | 208M00000X | 248415 | NY |
Addresses
Primary practice location
325 Meeting House LN
BLDG 2 Suite 403
Southampton, NY 11968-5087
Mailing address
PO Box 2340
Southampton, NY 11969-2340
Phone (631) 283-2100
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 248412 | Other | NY | LICENSE |
| 02978994 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- General Surgery
- Education
- Other, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
225 Windmill Lane
Southampton, NY 11968-4880
Phone (631) 287-6202
225 Windmill LN
Southampton, NY 11968-4880
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 75 of 100
Merit-based Incentive Payment System (MIPS)
- Final score
- 0 of 100
- Quality
- 0
- Improvement activities
- 0
- Cost
- 0
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 886 |
| Removal of skin lesions | 1-10 |
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 248415 | NY | MD | Pain Medicine (Anesthesiology) Physician |
| 248412 | NY | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Robert Marriott Medical Corp | Surgery | Current | Accepting new patients |
| Eastern Long Island Surgery PC | Surgery | Current | Accepting new patients |
| South Fork Medical Associates PC | Surgery | Past | Accepting new patients |
Locations
222 N Pacific Coast Hwy
Ste 2175
El Segundo, CA 90245
Phone (877) 850-8762
395 Sunken Meadow Rd
Kings Park, NY 11754
Phone (631) 269-5800
225 Windmill Ln
Southampton, NY 11968
Phone (631) 287-6202
Organizations & group practices 3
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.
-
- Surgery Physician
- Southampton, NY
- NPI 1699945378
-
dba Advantage Wound Care
- Surgery Physician
- El Segundo, CA
- NPI 1083883938
NY
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Stony Brook Southampton Hospital
- General Acute Care Hospital
- Southampton, NY
- NPI 1033224704
-
- General Acute Care Hospital
- Southampton, NY
- NPI 1225507114
-
- General Acute Care Hospital
- Greenport, NY
- NPI 1881690691
-
- General Acute Care Hospital
- Stony Brook, NY
- NPI 1972523348
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1209081600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1241222400000",
"number": "1013182591",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2340",
"city": "SOUTHAMPTON",
"state": "NY",
"postal_code": "119692340",
"telephone_number": "631-283-2100",
"fax_number": "631-283-5731"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "325 MEETING HOUSE LN",
"address_2": "BLDG 2 SUITE 403",
"city": "SOUTHAMPTON",
"state": "NY",
"postal_code": "119685087",
"telephone_number": "631-283-2100",
"fax_number": "631-283-5731"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TARASUK",
"first_name": "LAWRENCE",
"middle_name": "J",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-04-25",
"last_updated": "2009-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "NY",
"license": "248412",
"primary": true
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "NY",
"license": "248415",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "248412",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02978994",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Southampton, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2009; 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.