Individual provider Active NPI

Joshua H Lau, M.D.

  • Pediatrics Physician
  • Staten Island, NY
National Provider Identifier
1467422758
Registry record updated Apr 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
234775-1 Issued in NY
Practice address
2079 Forest Ave
Staten Island, NY 10303
Phone
(718) 815-6560
Fax
(718) 815-6570
NPI assigned
Jan 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 234775-1 NY Primary

Addresses

Primary practice location

2079 Forest Ave
Staten Island, NY 10303

Mailing address

2079 Forest Ave
Staten Island, NY 10303
Phone (718) 815-6560

Other identifiers 1

IdentifierTypeStateIssuer
02712985MedicaidNY

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110624000189 NY Practitioner - Pediatric Medicine 1355527706 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
234775-1NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beacon Christian Community Health Center Inc CurrentSince May 8, 2011 Accepting new patients
Beacon Christian Community Health Center, Inc. Pediatrics CurrentSince May 8, 2011 Accepting new patients

Locations

2031 Forest Ave
Staten Island, NY 10303
Phone (718) 815-6560

475 Seaview Ave
Staten Island, NY 10305
Phone (718) 226-8855

2079 Forest Ave
Staten Island, NY 10303
Phone (718) 815-6560

Networks

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

Interoperability endpoints

  • Direct secure messaging: joshua.lau.1@20119.direct.athenahealth.com

Organizations & group practices 2

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": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398729600000",
    "number": "1467422758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2079 FOREST AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10303",
            "telephone_number": "718-815-6560",
            "fax_number": "718-815-6570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2079 FOREST AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10303",
            "telephone_number": "718-815-6560",
            "fax_number": "718-815-6570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAU",
        "first_name": "JOSHUA",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-26",
        "last_updated": "2014-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "234775-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02712985",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.