Lawrence Lyons, MD

Individual provider Active NPI Family Medicine Physician · Cerrillos, NM

NPI 1043378060 · NPPES record last updated Jan 9, 2023

Key facts

NPI
1043378060
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
77-213 (NM)
Practice address
06B Main Street
Cerrillos, NM 87010
Phone
(505) 471-6266
Fax
(505) 471-5861
NPI assigned
Dec 4, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 4

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.

Medicare Care Compare profile

Specialty
Family Practice
Education
Jefferson Medical College of Thomas Jefferson University, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Presbyterian Medical Services (132 clinicians)

Practice addresses (Care Compare)

199 Hwy 50
Pecos, NM 87552
Phone (505) 757-6482

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20110720000640 NM Practitioner - Family Practice 2668640582 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
77-213NMMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Medical Services Current Accepting new patients
Presbyterian Medical Services Family Medicine Current
since May 23, 2016
Accepting new patients
Presbyterian Medical Services Current
since May 23, 2016
Accepting new patients
Presbyterian Medical Services Past
since Jan 15, 2023
Accepting new patients

Locations

835 Spruce St
Espanola, NM 87532
Phone (505) 614-6369

4730 Beckner Rd
Santa Fe, NM 87507
Phone (505) 989-4500

1422 Paseo de Peralta
Santa Fe, NM 87501
Phone (505) 982-5565

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 77-213 NM Yes

Addresses

Primary practice location

06B Main Street
Cerrillos, NM 87010

Mailing address

PO Box 2267
Santa Fe, NM 87504-2267
Phone (505) 820-3478

Other providers in Cerrillos, NM

All providers in Cerrillos, NM · Family Medicine Physician in New Mexico

Sources for this page

Verify at the official NPI Registry.