Individual provider Active NPI

Lawrence Jacowitz, DPM

  • Podiatrist
  • Kingston, NY
National Provider Identifier
1336199876
Registry record updated Feb 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
N002499 Issued in NY
Practice address
1 Family Practice Dr
Kingston, NY 12401-6449
Phone
(845) 338-6400
Fax
(845) 339-7288
NPI assigned
May 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X N002499 NY Primary

Addresses

Primary practice location

1 Family Practice Dr
Kingston, NY 12401-6449

Mailing address

279 Main St
Suite 204
New Paltz, NY 12561-1623
Phone (845) 255-3046

Other identifiers 1

IdentifierTypeStateIssuer
00414902MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031208000859 NY Practitioner - Podiatry 5991601312 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 1969
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Institute for Family HealthGroup PAC ID 9234048588, 188 clinicians

Practice addresses (Care Compare)

1 Family Practice Dr
Kingston, NY 12401-6449
Phone (845) 338-6400

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
N002499NYMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
The Institute for Family Health CurrentSince Mar 1, 2007 Accepting new patients
The Institute for Family Health CurrentSince Mar 1, 2007 Accepting new patients
Mid-Hudson Family Health Institute Podiatrist Past Accepting new patients

Locations

11 Crum Elbow Rd
Hyde Park, NY 12538
Phone (845) 229-1020

1 Family Practice Dr
Kingston, NY 12401
Phone (845) 338-2562

279 Main St
Ste 101
New Paltz, NY 12561
Phone (845) 255-2930

279 Main St
Ste 201
New Paltz, NY 12561
Phone (845) 255-2930

279 Main St
Ste 204
New Paltz, NY 12561
Phone (845) 255-3046

1824 Madison Ave
New York, NY 10035
Phone (212) 423-4200

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678

Organizations & group practices 3

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": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329955200000",
    "number": "1336199876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "279 MAIN ST",
            "address_2": "SUITE 204",
            "city": "NEW PALTZ",
            "state": "NY",
            "postal_code": "125611623",
            "telephone_number": "845-255-3046",
            "fax_number": "845-255-0236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 FAMILY PRACTICE DR",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124016449",
            "telephone_number": "845-338-6400",
            "fax_number": "845-339-7288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOWITZ",
        "first_name": "LAWRENCE",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2012-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "N002499",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00414902",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingston, NY

Sources for this page

Verify at the official NPI Registry.