Individual provider Active NPI

Frank John Lacqua, M.D.

  • Colon & Rectal Surgery Physician
  • Brooklyn, NY
National Provider Identifier
1154395507
Registry record updated May 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
175314 Issued in NY
Practice address
7513 Fort Hamilton Pkwy
Brooklyn, NY 11228-2305
Phone
(718) 680-6604
NPI assigned
Feb 14, 2006
Last updated
May 22, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 22, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Colon & Rectal Surgery Physician 208C00000X 175314 NY Primary

Addresses

Primary practice location

7513 Fort Hamilton Pkwy
Brooklyn, NY 11228-2305

Mailing address

7513 Fort Hamilton Pkwy
Brooklyn, NY 11228-2305
Phone (718) 680-6604

Other identifiers 1

IdentifierTypeStateIssuer
01265530MedicaidNY

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
I20040304000677 NY Practitioner - Colorectal Surgery (Proctology) 7618864497 Practice locations: Staten Island, NY

Care Compare profile

Medicare Care Compare
Specialty
Colorectal Surgery (Proctology)
Education
State University of New York at Buffalo School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2372 Victory Blvd
Staten Island, NY 10314-6607
Phone (718) 761-3700

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy375

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
175314NYMDColon & Rectal Surgery Physician

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369180800000",
    "number": "1154395507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7513 FORT HAMILTON PKWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112282305",
            "telephone_number": "718-680-6604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7513 FORT HAMILTON PKWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112282305",
            "telephone_number": "718-680-6604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACQUA",
        "first_name": "FRANK",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-14",
        "last_updated": "2013-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "NY",
            "license": "175314",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01265530",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.