Individual provider Active NPI

Lawrence Disini Cabusora, M.D.

  • Student in an Organized Health Care Education/Training Program
  • New York, NY
National Provider Identifier
1114201597
Registry record updated Oct 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
212 E 47TH St
Apartment 23F
New York, NY 10017-2128
Phone
(212) 644-5604
NPI assigned
Oct 4, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

212 E 47TH St
Apartment 23F
New York, NY 10017-2128

Mailing address

212 E 47TH St
Apartment 23F
New York, NY 10017-2128
Phone (212) 644-5604

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
I20160721001919 NY Practitioner - Diagnostic Radiology 5890088355 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CP Advanced Imaging PLLCGroup PAC ID 4385663582, 10 clinicians
Sunset Park Radiology PCGroup PAC ID 6608247291, 32 clinicians

Practice addresses (Care Compare)

155 Canal St
New York, NY 10013-4551
Phone (212) 431-9010

5521 8TH Ave
FL 6
Brooklyn, NY 11220-3515
Phone (718) 928-2588

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sunset Park Radiology PC CurrentSince Feb 20, 2024 Accepting new patients
CP Advanced Imaging PLLC CurrentSince Jul 1, 2016 Accepting new patients

Locations

5521 8th Ave
Fl 6
Brooklyn, NY 11220
Phone (718) 928-2588

155 Canal St
New York, NY 10013
Phone (212) 219-9135

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": "1317686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317686400000",
    "number": "1114201597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 E 47TH ST",
            "address_2": "APARTMENT 23F",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100172128",
            "telephone_number": "212-644-5604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 E 47TH ST",
            "address_2": "APARTMENT 23F",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100172128",
            "telephone_number": "212-644-5604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CABUSORA",
        "first_name": "LAWRENCE",
        "middle_name": "DISINI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-04",
        "last_updated": "2011-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.