Individual provider Active NPI

Lynnae Susan Lawrence, MD

  • Internal Medicine Physician
  • Honolulu, HI
National Provider Identifier
1063420164
Registry record updated May 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
20222 Issued in HI
Practice address
459 Patterson Rd
Honolulu, HI 96819-1522
Phone
(808) 433-0600
NPI assigned
Aug 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 5271 AK
Internal Medicine Physician 207R00000X 20222 HI Primary

Addresses

Primary practice location

459 Patterson Rd
Honolulu, HI 96819-1522

Mailing address

1134 Kukulu St Apt 606
Kapolei, HI 96707-4514
Phone (406) 702-0686

Other identifiers 1

IdentifierTypeStateIssuer
MD27921MedicaidAK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160418000890 MT Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 9537153200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
5271AKMDInternal Medicine Physician
20222HIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Frances Mahon Deaconess Hospital Past Accepting new patients
Dhew Ind HLTH SV HLTH SVS & MNTL HLTH Adm PastSince Apr 30, 2003 Accepting new patients

Organizations & group practices 2

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": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589587200000",
    "number": "1063420164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1134 KUKULU ST APT 606",
            "city": "KAPOLEI",
            "state": "HI",
            "postal_code": "967074514",
            "telephone_number": "406-702-0686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "459 PATTERSON RD",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968191522",
            "telephone_number": "808-433-0600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWRENCE",
        "first_name": "LYNNAE",
        "middle_name": "SUSAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-04",
        "last_updated": "2020-05-16",
        "certification_date": "2020-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AK",
            "license": "5271",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "HI",
            "license": "20222",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD27921",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.