Organization Active NPI

Spine Care Medicine PC

  • Internal Medicine Physician
  • Lawrence, NY
National Provider Identifier
1134929896
Registry record updated Mar 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
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, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2025

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)CodeLicenseStatePrimary
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 IDStateProvider typePAC IDDetails
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 Directory

Locations

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.

Verify at the official NPI Registry.