Individual provider Active NPI

Zachary Lawrence, MD

  • Plastic and Reconstructive Surgery Physician
  • Philadelphia, PA
National Provider Identifier
1205491628
Registry record updated May 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
MT237179 Issued in PA
Practice address
3401 N Broad St
Philadelphia, PA 19140-5189
Phone
(215) 707-7032
NPI assigned
May 2, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery Physician 2086S0122X MT237179 PA Primary
Surgery Physician 208600000X 0606 SD

Addresses

Primary practice location

3401 N Broad St
Philadelphia, PA 19140-5189

Mailing address

3401 N Broad St
Philadelphia, PA 19140-5189

Other practice location 1

1600 W 22nd St
Sioux Falls, SD 57105-1521
Phone (605) 312-4209

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
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
I20210901001244 SD Order and Referring Only - General SurgeryPractitioner - General Surgery 5395141220

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0606SDMDRegistered Dietitian
MT237179PAMDPlastic and Reconstructive Surgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1556755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778716800000",
    "number": "1205491628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405189",
            "telephone_number": "215-707-7032"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 W 22nd St",
            "address_purpose": "LOCATION",
            "city": "Sioux Falls",
            "state": "SD",
            "postal_code": "571051521",
            "country_code": "US",
            "telephone_number": "605-312-4209",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAWRENCE",
        "first_name": "ZACHARY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-02",
        "last_updated": "2026-05-14",
        "certification_date": "2026-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "PA",
            "license": "MT237179",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "SD",
            "license": "0606",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.