Individual provider Active NPI

Matthew W Lawrence, DO

  • Vascular Surgery Physician
  • Somers Point, NJ
National Provider Identifier
1093726101
Registry record updated Feb 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
OS010450L Issued in PA
Practice address
649 Shore Rd
Somers Point, NJ 08244-2449
Phone
(609) 365-6200
Fax
(609) 926-4311
NPI assigned
Aug 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X C20007648 DE
Vascular Surgery Physician 2086S0129X OS010450L PA Primary

Addresses

Primary practice location

649 Shore Rd
Somers Point, NJ 08244-2449

Mailing address

1 E. New York Ave
4TH Floor -SPG
Somers Point, NJ 08244
Phone (609) 653-3994

Other practice location 1

1500 Shallcross Ave
Ste 1 A
Wilmington, DE 19806-3037
Phone (302) 652-6050

Other identifiers 3

IdentifierTypeStateIssuer
0712591MedicaidNJ
1013649230003MedicaidPA
1000035617MedicaidDE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050215000745 PA Practitioner - Vascular SurgeryPractitioner - General SurgeryPractitioner - Thoracic SurgeryPractitioner - Peripheral Vascular Disease 3274585583 Reassigns benefits to 2 organizations
I20191230000863 NJ Practitioner - Vascular Surgery 3274585583 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Philadelphia College of Osteopathic Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shore Specialty ConsultantsGroup PAC ID 1951613652, 42 clinicians

Practice addresses (Care Compare)

155 Medical Ctr Way
Suite V First Floor
Somers Point, NJ 08244
Phone (609) 365-6239

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal1-10
Leg revascularization (restoring blood flow)25
Removal of tissue18

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C20007648DEMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shore Specialty Consultants CurrentSince Dec 1, 2019 Accepting new patients
Drexel University CurrentSince Jan 1, 2018 Accepting new patients
Drexel University Current Accepting new patients
Prospect Health Access Network, Inc. Current Accepting new patients
Prospect Health Access Network, Inc. CurrentSince Aug 1, 2017 Accepting new patients
Drexel University CurrentSince Jan 1, 2018 Accepting new patients
Prospect Health Access Network, Inc. CurrentSince Aug 1, 2017 Accepting new patients

Locations

1500 Shallcross Ave
Ste 1A
Wilmington, DE 19806
Phone (302) 407-2457

4 W Roosevelt Blvd
Marmora, NJ 08223
Phone (609) 365-6202

710 Center St
Fl 2
Somers Point, NJ 08244
Phone (609) 365-6280

649 Shore Rd
Somers Point, NJ 08244
Phone (609) 365-6239

155 Medical Center Way
Ste V
Somers Point, NJ 08244

1 Medical Center Blvd
Ste 233
Chester, PA 19013
Phone (610) 499-0400

1 Medical Center Blvd
#428
Chester, PA 19013
Phone (610) 874-4044

1 Medical Center Blvd
Chester, PA 19013
Phone (610) 447-6666

1 Medical Center Blvd
Ste 301
Chester, PA 19013
Phone (610) 566-6744

1427 Vine St
Fl 8
Philadelphia, PA 19102
Phone (215) 762-6660

1601 Cherry St
Ste 11511
Philadelphia, PA 19102

1427 Vine St
Fl 2
Philadelphia, PA 19102
Phone (215) 762-2530

100 W Sproul Rd
Ste 123
Springfield, PA 19064
Phone (610) 619-8281

Interoperability endpoints

  • Direct secure messaging: matthew.lawrence.1@4024.direct.athenahealth.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 4

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": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612224000000",
    "number": "1093726101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 E. NEW YORK AVE",
            "address_2": "4TH FLOOR -SPG",
            "city": "SOMERS POINT",
            "state": "NJ",
            "postal_code": "08244",
            "telephone_number": "609-653-3994",
            "fax_number": "609-926-4311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "649 SHORE RD",
            "city": "SOMERS POINT",
            "state": "NJ",
            "postal_code": "082442449",
            "telephone_number": "609-365-6200",
            "fax_number": "609-926-4311"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 Shallcross Ave",
            "address_2": "Ste 1 A",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "DE",
            "postal_code": "198063037",
            "country_code": "US",
            "telephone_number": "302-652-6050",
            "fax_number": "302-652-6053",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAWRENCE",
        "first_name": "MATTHEW",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-11",
        "last_updated": "2021-02-02",
        "certification_date": "2021-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "DE",
            "license": "C20007648",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "PA",
            "license": "OS010450L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0712591",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013649230003",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000035617",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Somers Point, NJ

Sources for this page

Verify at the official NPI Registry.