Individual provider Active NPI

Kenneth J Laurora, MD

  • Internal Medicine Physician
  • Livingston, TX
National Provider Identifier
1184606378
Registry record updated Dec 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
L6237 Issued in TX
Practice address
300 Bypass LN
Suite 208
Livingston, TX 77351-8413
Phone
(936) 327-1020
Fax
(936) 327-1022
NPI assigned
Nov 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X L6237 TX Primary

Addresses

Primary practice location

300 Bypass LN
Suite 208
Livingston, TX 77351-8413

Mailing address

300 Bypass LN
Suite 208
Livingston, TX 77351-8413
Phone (936) 327-1020

Other identifiers 2

IdentifierTypeStateIssuer
158661202MedicaidTX
296647502MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20031124000185 TX Practitioner - Internal Medicine 7517861313 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Rutgers New Jersey Medical School, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

300 Bypass LN
Suite 208
Livingston, TX 77351-8532
Phone (936) 327-1020

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Quality
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
L6237TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kenneth J Laurora MD PA Internal Medicine CurrentSince Oct 1, 2010 Accepting new patients

Locations

400 Bypass Ln
Ste 111
Livingston, TX 77352
Phone (936) 327-0199

300 Bypass Ln
Ste 208
Livingston, TX 77352
Phone (936) 327-1020

Interoperability endpoints

  • Direct secure messaging: admin@kennethjlauroramdpa.e-mdsdirect.com

Organizations & group practices 1

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.

Hospital & facility affiliations 4

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": "1132012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482364800000",
    "number": "1184606378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 BYPASS LN",
            "address_2": "SUITE 208",
            "city": "LIVINGSTON",
            "state": "TX",
            "postal_code": "773518413",
            "telephone_number": "936-327-1020",
            "fax_number": "936-327-1022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 BYPASS LN",
            "address_2": "SUITE 208",
            "city": "LIVINGSTON",
            "state": "TX",
            "postal_code": "773518413",
            "telephone_number": "936-327-1020",
            "fax_number": "936-327-1022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAURORA",
        "first_name": "KENNETH",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-15",
        "last_updated": "2016-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "L6237",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "158661202",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "296647502",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Livingston, TX

Sources for this page

Verify at the official NPI Registry.