NPIMap

Individual provider Active NPI

Lawrence Salob, D.O.

  • Family Medicine Physician
  • Smithtown, NY
National Provider Identifier
1225053580
Registry record updated Feb 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
229232 Issued in NY
Practice address
100 Terry Rd Ste 309
Smithtown, NY 11787-3811
Phone
(631) 979-7400
Fax
(631) 979-7440
NPI assigned
Jul 13, 2006
Last updated
Feb 8, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 229232 NY Primary

Addresses

Primary practice location

100 Terry Rd Ste 309
Smithtown, NY 11787-3811

Mailing address

100 Terry Rd
Smithtown, NY 11787-3811
Phone (631) 979-7400

Other identifiers 1

IdentifierTypeStateIssuer
02868082MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041021000685 NY Practitioner - Family PracticePractitioner - Osteopathic Manipulative Medicine 5092776245 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Osteopathic Manipulative Medicine
Education
New York College of Osteo Medicine of New York Institute of Technology, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
E.Lila Augoustiniatos, MD, PCGroup PAC ID 7911994140, 3 clinicians

Practice addresses (Care Compare)

100 Terry Rd
Smithtown, NY 11787-3811
Phone (631) 979-7400

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
229232NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
E.Lila Augoustiniatos, MD, PC CurrentSince Aug 16, 2021 Accepting new patients
Long Island Family Medical Family Medicine Past Accepting new patients
Island Medical Empire State, PLLC Family Medicine PastSince Feb 5, 2009 Accepting new patients
Good Will Medical, P.C. Family Medicine Past Accepting new patients
Long Island Integrative Functional Medicine, PC PastSince Aug 16, 2021 Accepting new patients
Island Urgent Medical Care, P.C. Family Medicine Past Accepting new patients
Peninsula Medical Services PC Family Medicine Past Accepting new patients
New York Institute of Technology Family Medicine Past Accepting new patients
Long Island Family Medical Group PC Family Medicine Past Accepting new patients
Good Will Medical, P.C. Past Accepting new patients
New York Institute of Technology Family Medicine Past Accepting new patients

Locations

100 Terry Rd
Smithtown, NY 11787
Phone (631) 979-7301

100 Terry Rd
Ste 309
Smithtown, NY 11787
Phone (631) 979-7400

Organizations & group practices 11

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.

Hospital & facility affiliations 10

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": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707350400000",
    "number": "1225053580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 TERRY RD",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117873811",
            "telephone_number": "631-979-7400",
            "fax_number": "631-979-7440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 TERRY RD STE 309",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117873811",
            "telephone_number": "631-979-7400",
            "fax_number": "631-979-7440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALOB",
        "first_name": "LAWRENCE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2024-02-08",
        "certification_date": "2024-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "229232",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02868082",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithtown, NY

Sources for this page

Verify at the official NPI Registry.