Organization Active NPI

Lawrence Marc Jacobson MD PLLC

  • Ophthalmology Physician
  • Brooklyn, NY
National Provider Identifier
1013192566
Registry record updated Jul 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
191576 Issued in NY
Legal business name
LAWRENCE MARC JACOBSON MD PLLC
Practice address
128 Lee Ave
Brooklyn, NY 11211-8417
Phone
(212) 981-9812
NPI assigned
Jan 3, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2025

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

Authorized official

Name
Dr. Lawrence M Jacobson, MDNPI 1184627465
Title
Owner
Phone
(212) 981-9812

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X 191576 NY Primary

Addresses

Primary practice location

128 Lee Ave
Brooklyn, NY 11211-8417

Mailing address

128 Lee Ave
Brooklyn, NY 11211-8417
Phone (212) 981-9812

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110912000430 NY Part B Supplier - Clinic/Group Practice 4486545233 Receives reassigned benefits from 2 practitioners
Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory

Locations

1479 48th St
Brooklyn, NY 11219
Phone (718) 534-0331

128 Lee Ave
Brooklyn, NY 11211
Phone (212) 981-9812

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1199318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753747200000",
    "number": "1013192566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 LEE AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112118417",
            "telephone_number": "212-981-9812",
            "fax_number": "212-981-9813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 LEE AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112118417",
            "telephone_number": "212-981-9812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAWRENCE MARC JACOBSON MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-03",
        "last_updated": "2025-07-29",
        "certification_date": "2025-07-11",
        "status": "A",
        "authorized_official_last_name": "JACOBSON",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "212-981-9812",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "191576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.