Individual provider Active NPI

Luis Fernando Laos, MD

  • Pulmonary Disease Physician
  • Orange Park, FL
National Provider Identifier
1407815525
Registry record updated Jan 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
ME70461 Issued in FL
Practice address
1893 Kingsley Ave
Suite C
Orange Park, FL 32073-4491
Phone
(904) 276-2044
Fax
(904) 276-2106
NPI assigned
Mar 18, 2006
Last updated
Jan 23, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME70461 FL
Critical Care Medicine (Internal Medicine) Physician 207RC0200X ME70461 FL
Pulmonary Disease Physician 207RP1001X ME70461 FL Primary

Addresses

Primary practice location

1893 Kingsley Ave
Suite C
Orange Park, FL 32073-4491

Mailing address

1893 Kingsley Ave
Suite C
Orange Park, FL 32073-4491
Phone (904) 276-2044

Other identifiers 3

IdentifierTypeStateIssuer
000804185AMedicaidGA
2552507-00MedicaidFL
110181012OtherFLRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20070504000314 FL Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 3577669787 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eugene H McCoskey DO PAGroup PAC ID 2961781984, 4 clinicians

Practice addresses (Care Compare)

1555 Kingsley Ave
Suite 404
Orange Park, FL 32073-9207
Phone 9043883357201

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME70461FLMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eugene H McCoskey, D.O., P.a. Pulmonary Disease CurrentSince Aug 15, 2018 Accepting new patients

Locations

1555 Kingsley Ave
Ste 404
Orange Park, FL 32073
Phone (904) 215-0700

Interoperability endpoints

  • Direct secure messaging: luis.laos.1@8967.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1142640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327276800000",
    "number": "1407815525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1893 KINGSLEY AVE",
            "address_2": "SUITE C",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734491",
            "telephone_number": "904-276-2044",
            "fax_number": "904-276-2106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1893 KINGSLEY AVE",
            "address_2": "SUITE C",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734491",
            "telephone_number": "904-276-2044",
            "fax_number": "904-276-2106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAOS",
        "first_name": "LUIS",
        "middle_name": "FERNANDO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-18",
        "last_updated": "2012-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME70461",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "FL",
            "license": "ME70461",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "FL",
            "license": "ME70461",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000804185A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2552507-00",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110181012",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange Park, FL

Sources for this page

Verify at the official NPI Registry.