Individual provider Active NPI

Lawrence Ezra Shapiro, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Mineola, NY
National Provider Identifier
1144299777
Registry record updated Mar 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
115548 Issued in NY
Practice address
101 Mineola Blvd
2ND Floor
Mineola, NY 11501-4007
Phone
(516) 663-3511
Fax
(516) 663-4780
NPI assigned
Mar 16, 2006
Last updated
Mar 31, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 115548 NY Primary

Addresses

Primary practice location

101 Mineola Blvd
2ND Floor
Mineola, NY 11501-4007

Mailing address

101 Mineola Blvd
2ND Floor
Mineola, NY 11501-4007
Phone (516) 663-3511

Other identifiers 1

IdentifierTypeStateIssuer
00833601MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lshapiro238894@nyumc.direct-ci.com Direct

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
I20100920000648 NY Practitioner - Endocrinology 4284759853 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
115548NYMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Oct 1, 2018 Accepting new patients
New York University CurrentSince Oct 1, 2018 Accepting new patients
Medical Group of Mineola, PC Past Accepting new patients

Locations

1300 Franklin Ave
Ste ML6
Garden City, NY 11530
Phone (516) 353-1900

1300 Franklin Ave
Ste Ul
Garden City, NY 11530
Phone (516) 663-2224

340 W Park Ave
Long Beach, NY 11561
Phone (516) 431-5064

101 Mineola Blvd
Fl 2
Mineola, NY 11501
Phone (516) 633-3511

120 Mineola Blvd
Ste 600
Mineola, NY 11501
Phone (516) 663-4525

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1144299777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 MINEOLA BLVD",
            "address_2": "2ND FLOOR",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115014007",
            "telephone_number": "516-663-3511",
            "fax_number": "516-663-4780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MINEOLA BLVD",
            "address_2": "2ND FLOOR",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115014007",
            "telephone_number": "516-663-3511",
            "fax_number": "516-663-4780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAPIRO",
        "first_name": "LAWRENCE",
        "middle_name": "EZRA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-16",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NY",
            "license": "115548",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00833601",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lshapiro238894@nyumc.direct-ci.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "101 Mineola Blvd",
            "address_2": "2ND FLOOR",
            "city": "Mineola",
            "state": "NY",
            "country_code": "US",
            "postal_code": "115014007",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mineola, NY

Sources for this page

Verify at the official NPI Registry.