Lawrence Wine, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

159728-1 Issued in NY

Practice address

129 Slosson Ave
Staten Island, NY 10314-2522

Phone

(718) 226-2000

NPI assigned

Jul 13, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY, 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

Specialty

Anesthesiology

Education

State University of New York Downstate Medical Center, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wine Anesthesia LLCGroup PAC ID 4688769094, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

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

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.

• Wine Anesthesia, LLC

  • Anesthesiology Physician
  • Staten Island, NY
  • NPI 1407984255
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1121212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618963200000",
    "number": "1114925013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 120223",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103120223",
            "telephone_number": "718-663-9251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 SLOSSON AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103142522",
            "telephone_number": "718-226-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINE",
        "first_name": "LAWRENCE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-13",
        "last_updated": "2021-04-21",
        "certification_date": "2021-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "159728-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00188256",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda M Winant
• Alexa Layne Winchel, OTR/L
• Lissa Dale Winchel, LCSW
• Neil Winchel
• Wine Anesthesia, LLC
• Georgener Winfield
• Samantha Harris Winitsky, M.S. CCC-SLP/TSSLD
• Kaitlin Winslow, MSOT
• Katrina Lisa Winslow, MSED, ABA
• Nicole Winston

• Anesthesiology Physician in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Anesthesiology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.