Individual provider Active NPI

Lawrence Waxman, RPA-C

  • Surgical Physician Assistant
  • Massapequa, NY
National Provider Identifier
1033491303
Registry record updated Jun 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
008930 Issued in NY
Practice address
5500 Merrick Rd
Massapequa, NY 11758-6231
Phone
(516) 795-3033
NPI assigned
Sep 13, 2011
Last updated
Jun 22, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 008930 NY Primary

Addresses

Primary practice location

5500 Merrick Rd
Massapequa, NY 11758-6231

Mailing address

5500 Merrick Rd
Massapequa, NY 11758-6231
Phone (516) 795-3033

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160505000670 NY Practitioner - Physician Assistant 9234438748 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedics Spine and Sports Medicine, LLC Current Accepting new patients
Orthopaedics Spine and Sports Medicine LLC CurrentSince Mar 18, 2016 Accepting new patients
Beth Israel Medical Center Past Accepting new patients

Locations

2510 Westchester Ave
Ste 100
Bronx, NY 10461
Phone (718) 684-4677

1789 Sheepshead Bay Rd
Brooklyn, NY 11235
Phone (347) 587-1049

2103 Deer Park Ave
Deer Park, NY 11729
Phone (631) 242-4500

2201 Hempstead Tpke
East Meadow, NY 11554
Phone (516) 486-6862

2339 Hempstead Tpke
East Meadow, NY 11554
Phone (516) 520-3053

12 Unqua Rd
Massapequa, NY 11758

5500 Merrick Rd
Massapequa, NY 11758
Phone (516) 797-2657

115 Eileen Way
Syosset, NY 11791
Phone (516) 622-9797

Interoperability endpoints

  • Direct secure messaging: lawrencewaxman@ossm.allscriptsdirect.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1315872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466553600000",
    "number": "1033491303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 MERRICK RD",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117586231",
            "telephone_number": "516-795-3033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 MERRICK RD",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117586231",
            "telephone_number": "516-795-3033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAXMAN",
        "first_name": "LAWRENCE",
        "name_prefix": "Mr.",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-13",
        "last_updated": "2016-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "008930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Massapequa, NY

Sources for this page

Verify at the official NPI Registry.