Active NPI
Spine Care Medicine PC
- Internal Medicine Physician
- Lawrence, NY
National Provider Identifier
1134929896
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- Legal business name
- SPINE CARE MEDICINE PC
- Practice address
- 48 Frost LN Unit a
Lawrence, NY 11559-1806 - Phone
- (516) 862-1202
- Fax
- (516) 758-1278
- NPI assigned
- Mar 13, 2025
- Last updated
- Mar 13, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Abraham D Knoll, MD
- Title
- Owner
- Phone
- (551) 206-1222
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | NU | Primary |
Addresses
Primary practice location
48 Frost LN Unit a
Lawrence, NY 11559-1806
Mailing address
48 Frost LN Unit a
Lawrence, NY 11559-1806
Phone (516) 862-1202
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20250331000871 | NY | Part B Supplier - Clinic/Group Practice | 0042733164 | Practice locations: Oneonta, NY; Plattsburgh, NY; Rochester, NY; Rome, NY; Stamford, NY; Utica, NY; Valatie, NY; Whitestone, NY… |
National Provider Directory
National Provider DirectoryLocations
1 Long Beach Rd
Island Park, NY 11558
Phone (516) 432-0300
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1741824000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1741824000000",
"number": "1134929896",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "48 FROST LN UNIT A",
"city": "LAWRENCE",
"state": "NY",
"postal_code": "115591806",
"telephone_number": "516-862-1202",
"fax_number": "516-758-1278"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "48 FROST LN UNIT A",
"city": "LAWRENCE",
"state": "NY",
"postal_code": "115591806",
"telephone_number": "516-862-1202",
"fax_number": "516-758-1278"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SPINE CARE MEDICINE PC",
"organizational_subpart": "NO",
"enumeration_date": "2025-03-13",
"last_updated": "2025-03-13",
"certification_date": "2025-03-13",
"status": "A",
"authorized_official_last_name": "KNOLL",
"authorized_official_first_name": "ABRAHAM",
"authorized_official_middle_name": "D",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "551-206-1222",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lawrence, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.