NPIMap

Organization Active NPI

Renaissance Medical Care, P.C.

  • Family Medicine Physician
  • East Meadow, NY
National Provider Identifier
1346775889
Registry record updated Jan 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
236983 Issued in NY
Legal business name
RENAISSANCE MEDICAL CARE, P.C.
Practice address
1704 Noble St
East Meadow, NY 11554-5007
Phone
(516) 862-0200
NPI assigned
Apr 21, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2023

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

Authorized official

Name
Dr. Tanesha D Lawrence, MDNPI 1548330749
Title
Ceo
Phone
(917) 346-0543

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 236983 NY Primary

Addresses

Primary practice location

1704 Noble St
East Meadow, NY 11554-5007

Mailing address

894 Bedford Ave
Brooklyn, NY 11205-3913
Phone (718) 222-5999

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171017000925 NY Part B Supplier - Clinic/Group Practice 1759657927 Receives reassigned benefits from 6 practitioners
Practice locations: East Meadow, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1492732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672790400000",
    "number": "1346775889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "894 BEDFORD AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112053913",
            "telephone_number": "718-222-5999",
            "fax_number": "718-387-6429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1704 NOBLE ST",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "115545007",
            "telephone_number": "516-862-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAISSANCE MEDICAL CARE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-21",
        "last_updated": "2023-01-04",
        "certification_date": "2023-01-04",
        "status": "A",
        "authorized_official_last_name": "LAWRENCE",
        "authorized_official_first_name": "TANESHA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "917-346-0543",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "236983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Meadow, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.