Laurence F Mack, MD

Primary specialty

SpecialistTaxonomy code 174400000X

License

168820 Issued in NY

Practice address

627 Broadway
N Massapequa, NY 11758-5031

Phone

(516) 799-3462

Fax

(516) 799-5930

NPI assigned

Jul 24, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 11, 2018 through Jan 11, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: laurence.mack@2782.securemail.prognocis.com

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.

• Infertility Associates

  • Specialist
  • North Massapequa, NY
  • NPI 1104845346
  NPD (past) Authorized official

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194747444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "627 BROADWAY",
            "address_2": "PO BOX 1550",
            "city": "N MASSAPEQUA",
            "state": "NY",
            "postal_code": "117585031",
            "telephone_number": "516-799-3462",
            "fax_number": "516-799-5930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "627 BROADWAY",
            "city": "N MASSAPEQUA",
            "state": "NY",
            "postal_code": "117585031",
            "telephone_number": "516-799-3462",
            "fax_number": "516-799-5930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "LAURENCE",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "168820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Haas LCSW & Associates
• Marylou Lawson
• Lindenhurst PT & Pta PLLC (Lindenhurst Physical Therapy)
• Donna Loschiavo
• Melissa Marie Lyons, M.S.,P.T.
• Theresa Mackey
• Donna Lynne Macpherson, MA, CCC-SLP
• Christine Martha Malinauskas, P.T.
• Mary Ann McGrath, LCSW
• Massapequa PT & Pta PLLC (Pequa Physical & Aquatic Therapy, PLLC)

• Specialist in N Massapequa, NY
• Providers in N Massapequa, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.