NPIMap

Individual provider Active NPI

Lauren McCormack, M.D., M.P.H.

  • Surgery Physician
  • Philadelphia, PA
National Provider Identifier
1114281128
Registry record updated Jun 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MT202127 Issued in PA
Practice address
230 N Broad St
Philadelphia, PA 19102-1121
Phone
(215) 762-4157
NPI assigned
Jun 25, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MT202127 PA Primary

Addresses

Primary practice location

230 N Broad St
Philadelphia, PA 19102-1121

Mailing address

230 N Broad St
Philadelphia, PA 19102-1121

Other names 1

  • Lauren Boyle Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180807002070 PA Practitioner - General Surgery 2163770199 Reassigns benefits to 1 organization
I20200312001420 NC Practitioner - General Surgery 2163770199 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT202127PAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest University Health Sciences CurrentSince Jan 27, 2020 Accepting new patients
Drexel University CurrentSince Sep 1, 2018 Accepting new patients
Drexel University Current Accepting new patients
Drexel University CurrentSince Sep 1, 2018 Accepting new patients
Wake Forest University Health Sciences CurrentSince Jan 27, 2020 Accepting new patients

Locations

10 Medical Park Dr
Lexington, NC 27292
Phone (336) 236-4681

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

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

230 N Broad St
Philadelphia, PA 19102
Phone (215) 255-3828

Interoperability endpoints

  • Direct secure messaging: lmccormack2754848@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 20

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.

View all 20

Hospital & facility affiliations 6

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

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Tulane University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wake Forest University Health Sciences 2,633 clinicians

Practice addresses (Care Compare)

404 Westwood Ave
High Point, NC 27262-4316

4610 Country Club Rd
Winston Salem, NC 27104-3520
Phone (336) 716-2255

4614 Country Club Rd
Winston Salem, NC 27104-3520
Phone (336) 716-2255

4618 Country Club Rd
Winston Salem, NC 27104-3520
Phone (336) 716-3926

601 N Elm St
High Point, NC 27262-4331
Phone (336) 716-2734

Medical Ctr Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-2734

Hospital & facility affiliations

  • North Carolina Baptist Hospital Hospital, Winston-Salem, NC, CCN 340047
  • High Point Regional Health System Hospital, High Point, NC, CCN 340004

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

NPI Registry JSON

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

{
    "created_epoch": "1340582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340755200000",
    "number": "1114281128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191021121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191021121",
            "telephone_number": "215-762-4157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCORMACK",
        "first_name": "LAUREN",
        "credential": "M.D., M.P.H.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-25",
        "last_updated": "2012-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MT202127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAUREN",
            "last_name": "BOYLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.