Individual provider Active NPI

Lawrence J McMaster, DO

  • Internal Medicine Physician
  • Ann Arbor, MI
National Provider Identifier
1316028541
Registry record updated Jan 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
5101011410 Issued in MI
Practice address
2211 Old Earhart Rd Ste 195
Ann Arbor, MI 48105-2963
Phone
(734) 615-9200
Fax
(734) 615-9205
NPI assigned
Oct 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2021

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 5101011410 MI Primary

Addresses

Primary practice location

2211 Old Earhart Rd Ste 195
Ann Arbor, MI 48105-2963

Mailing address

3621 S State St
Ann Arbor, MI 48108-1633
Phone (734) 647-5299

Other identifiers 1

IdentifierTypeStateIssuer
1316028541MedicaidMI

Medicare participation

Medicare enrollment files
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 Nov 1, 2020 through Nov 1, 2026

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101011410MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Clarkston Lakes Family Medicine LLC PastSince Jan 24, 2021 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: lmcmaster26932@direct.med.umich.edu

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.

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610928000000",
    "number": "1316028541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081633",
            "telephone_number": "734-647-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 OLD EARHART RD STE 195",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481052963",
            "telephone_number": "734-615-9200",
            "fax_number": "734-615-9205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMASTER",
        "first_name": "LAWRENCE",
        "middle_name": "J",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2021-01-18",
        "certification_date": "2021-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5101011410",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1316028541",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.