Lawrence Trinidad San Jose, M.D.
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Indepedence, MO
NPI 1194529362 · NPPES record last updated Oct 22, 2025
Key facts
- NPI
- 1194529362
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- Practice address
- 19600 East 39TH St S
Centerpoint Medical Center
Indepedence, MO 64057 - Phone
- (913) 396-3807
- NPI assigned
- Apr 4, 2025
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251029001506 | MO | Order and Referring Only - Internal Medicine |
9133618291 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Interoperability endpoints
- lawrence.sanjose@hca2.eclinicaldirectplus.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Yes |
Addresses
Primary practice location
19600 East 39TH St S
Centerpoint Medical Center
Indepedence, MO 64057
Mailing address
19600 E 39TH St S
Independence, MO 64057-2301
Phone (913) 456-3077
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 22, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.