NPIMap

Individual provider Active NPI

Douglas Lax, DO

  • Nephrology Physician
  • Rockville Centre, NY
National Provider Identifier
1093790800
Registry record updated Oct 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
158526 Issued in NY
Practice address
242 Merrick Rd
Suite 304
Rockville Centre, NY 11570-5254
Phone
(516) 764-7070
Fax
(516) 764-7073
NPI assigned
Dec 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 158526 NY Primary

Addresses

Primary practice location

242 Merrick Rd
Suite 304
Rockville Centre, NY 11570-5254

Mailing address

242 Merrick Rd
Suite 304
Rockville Centre, NY 11570-5254
Phone (516) 764-7070

Other identifiers 1

IdentifierTypeStateIssuer
01085592MedicaidNY

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
I20100922001057 NY Practitioner - Nephrology 7618980699 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
New York College of Osteo Medicine of New York Institute of Technology, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Prine Health Medical Group, PLLCGroup PAC ID 1557600384, 77 clinicians

Practice addresses (Care Compare)

20110 Northern Blvd
Suite 304
Bayside, NY 11361-2542
Phone (516) 407-2727

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
158526NYMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prine Health Medical Group, PLLC Nephrology CurrentSince Apr 1, 2019 Accepting new patients
Prine Health Medical Group, PLLC CurrentSince Apr 1, 2019 Accepting new patients
Prohealth Care Associates, LLP Past Accepting new patients
Peninsula Medical Services PC Past Accepting new patients

Locations

20110 Northern Blvd
Ste 304
Bayside, NY 11361
Phone (516) 407-2727

250 Pettit Ave
#101
Bellmore, NY 11710

250 Pettit Ave
Ste 101
Bellmore, NY 11710

370 Old Country Rd
Ste 100
Garden City, NY 11530
Phone (516) 222-1000

1129 Northern Blvd
Ste 101
Manhasset, NY 11030
Phone (516) 365-5570

364 Merrick Rd
Rockville Centre, NY 11570
Phone (516) 536-3366

Networks

  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: ldouglas@prine.curemd.direct-ci.com

Organizations & group practices 4

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 10

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": "1134518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256860800000",
    "number": "1093790800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "242 MERRICK RD",
            "address_2": "SUITE 304",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115705254",
            "telephone_number": "516-764-7070",
            "fax_number": "516-764-7073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "242 MERRICK RD",
            "address_2": "SUITE 304",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115705254",
            "telephone_number": "516-764-7070",
            "fax_number": "516-764-7073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAX",
        "first_name": "DOUGLAS",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-14",
        "last_updated": "2009-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "158526",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01085592",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville Centre, NY

Sources for this page

Verify at the official NPI Registry.