Individual provider Active NPI

Theresa C. Lanzone, M.D.

  • Pediatric Adolescent Medicine Physician
  • Long Beach, NY
National Provider Identifier
1063596898
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
155668 Issued in NY
Practice address
350 National Blvd
Suite 2C
Long Beach, NY 11561-3327
Phone
(516) 432-0545
Fax
(516) 432-0597
NPI assigned
Oct 25, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X 155668 NY Primary

Addresses

Primary practice location

350 National Blvd
Suite 2C
Long Beach, NY 11561-3327

Mailing address

350 National Blvd
Suite 2C
Long Beach, NY 11561-3327
Phone (516) 432-0545

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220604000023 NY Practitioner - Pediatric Medicine 0446638399 Practice locations: Long Beach, NY

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
New York Medical College, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

350 National Blvd
2C
Long Beach, NY 11561-3327

National Provider Directory

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

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063596898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 NATIONAL BLVD",
            "address_2": "SUITE 2C",
            "city": "LONG BEACH",
            "state": "NY",
            "postal_code": "115613327",
            "telephone_number": "516-432-0545",
            "fax_number": "516-432-0597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 NATIONAL BLVD",
            "address_2": "SUITE 2C",
            "city": "LONG BEACH",
            "state": "NY",
            "postal_code": "115613327",
            "telephone_number": "516-432-0545",
            "fax_number": "516-432-0597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANZONE",
        "first_name": "THERESA",
        "middle_name": "C.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "NY",
            "license": "155668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, NY

Sources for this page

Verify at the official NPI Registry.