Individual provider Active NPI

Lawrence Forur, O.D.

  • Optometrist
  • Islip, NY
National Provider Identifier
1023081247
Registry record updated Feb 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV004284 Issued in NY
Practice address
150 Islip Ave
Suite 12
Islip, NY 11751-3222
Phone
(631) 581-5100
Fax
(631) 581-7512
NPI assigned
Feb 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV004284 NY Primary

Addresses

Primary practice location

150 Islip Ave
Suite 12
Islip, NY 11751-3222

Mailing address

150 Islip Ave
Islip, NY 11751-3222
Phone (631) 491-6248

Other identifiers 1

IdentifierTypeStateIssuer
00887274MedicaidNY

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110718000385 NY Practitioner - Optometry 4587787619 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
State University of New York - State College Optometry, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

150 Islip Ave
Suite 12
Islip, NY 11751-3222
Phone (631) 581-5100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV004284NYMDOptometrist
004284NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Vision Care, Inc. Optometrist CurrentSince Jan 1, 1989 Accepting new patients

Locations

150 Islip Ave
Ste 12
Islip, NY 11751
Phone (516) 581-5100

150 Islip Ave
Islip, NY 11751
Phone (631) 859-3420

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": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329177600000",
    "number": "1023081247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 ISLIP AVE",
            "city": "ISLIP",
            "state": "NY",
            "postal_code": "117513222",
            "telephone_number": "631-491-6248",
            "fax_number": "631-581-7512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 ISLIP AVE",
            "address_2": "SUITE 12",
            "city": "ISLIP",
            "state": "NY",
            "postal_code": "117513222",
            "telephone_number": "631-581-5100",
            "fax_number": "631-581-7512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORUR",
        "first_name": "LAWRENCE",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-08",
        "last_updated": "2012-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV004284",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00887274",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Islip, NY

Sources for this page

Verify at the official NPI Registry.