Active NPI
Lawrence Marc Vincent, MD
- Diagnostic Ultrasound Physician
- Boston, MA
National Provider Identifier
1053390146
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Ultrasound Physician
- License
- 220062
- Practice address
- 75 Francis St
Radiology Brigham & Womans Hospital
Boston, MA 02115 - Phone
- (617) 732-6280
- NPI assigned
- Jan 17, 2006
- 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 |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 220062 | MA | |
| Diagnostic Ultrasound Physician | 2085U0001X | 220062 | MA | Primary |
Addresses
Primary practice location
75 Francis St
Radiology Brigham & Womans Hospital
Boston, MA 02115
Mailing address
75 Francis St
Radiology Brigham & Womans Hospital
Boston, MA 02115
Phone (617) 732-6280
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2036169 | Medicaid | MA | |
| 453585 | Other | MA | TUFTS HEALTH PLAN |
| J27199 | Other | MA | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137456000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1347408000000",
"number": "1053390146",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "75 FRANCIS ST",
"address_2": "RADIOLOGY BRIGHAM & WOMANS HOSPITAL",
"city": "BOSTON",
"state": "MA",
"postal_code": "02115",
"telephone_number": "617-732-6280"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "75 FRANCIS ST",
"address_2": "RADIOLOGY BRIGHAM & WOMANS HOSPITAL",
"city": "BOSTON",
"state": "MA",
"postal_code": "02115",
"telephone_number": "617-732-6280"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VINCENT",
"first_name": "LAWRENCE",
"middle_name": "MARC",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-17",
"last_updated": "2012-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "MA",
"license": "220062",
"primary": false
},
{
"code": "2085U0001X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Ultrasound",
"state": "MA",
"license": "220062",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2036169",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS HEALTH PLAN",
"identifier": "453585",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "J27199",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.