NPIMap

Individual provider Active NPI

Lars David Thompson, MD

  • Urology Physician
  • Canton, NY
National Provider Identifier
1063511772
Registry record updated Oct 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
217623 Issued in NY
Practice address
80 E Main St Ste 2a
Canton, NY 13617-1400
Phone
(315) 714-2559
Fax
(315) 386-3056
NPI assigned
Sep 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 217623 NY Primary

Addresses

Primary practice location

80 E Main St Ste 2a
Canton, NY 13617-1400

Mailing address

100 Metropolitan Park Dr Ste 100
Liverpool, NY 13088-7112
Phone (315) 870-9369

Other identifiers 1

IdentifierTypeStateIssuer
02082882MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040715000411 NY Practitioner - Urology 2264411107 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Claxton-Hepburn Medical CenterGroup PAC ID 8426966508, 78 clinicians
Carthage Area Hospital IncGroup PAC ID 9931010485, shared by 16 NPIs, 119 clinicians
Associated Medical Professionals of Ny PLLCGroup PAC ID 0749378123, 57 clinicians

Practice addresses (Care Compare)

214 King St
Ogdensburg, NY 13669-1142
Phone (315) 393-3600

80 E Main St
Canton, NY 13617-1450
Phone (315) 714-2559

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
217623NYMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Medical Professionals of Ny, PLLC Urology CurrentSince Apr 15, 2022 Accepting new patients
Associated Medical Professionals of Ny, PLLC Urology CurrentSince Apr 15, 2022 Accepting new patients
Melchiore Buscemi, MD PC Urology Past Accepting new patients
Dr Stephen D Fisher DDS PC Past Accepting new patients
Canton Potsdam Hospital PastSince Oct 9, 2022 Accepting new patients
Sandstone Family Dentistry, P.C. Past Accepting new patients

Locations

80 E Main St
Ste 2A
Canton, NY 13617
Phone (315) 714-2559

80 E Main St
Canton, NY 13617
Phone (315) 261-6034

100 Metropolitan Park Dr
Ste 100
Liverpool, NY 13088
Phone (315) 870-9370

1226 E Water St
Syracuse, NY 13210
Phone (315) 423-7226

Interoperability endpoints

  • Direct secure messaging: lthompson@ampofny.medentdirect.com

Organizations & group practices 7

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665014400000",
    "number": "1063511772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 METROPOLITAN PARK DR STE 100",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130887112",
            "telephone_number": "315-870-9369",
            "fax_number": "315-870-9364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 E MAIN ST STE 2A",
            "city": "CANTON",
            "state": "NY",
            "postal_code": "136171400",
            "telephone_number": "315-714-2559",
            "fax_number": "315-386-3056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "LARS",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2022-10-06",
        "certification_date": "2022-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NY",
            "license": "217623",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02082882",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, NY

Sources for this page

Verify at the official NPI Registry.