Active NPI
Brian David Lamere, MD
- General Practice Physician
- Dekalb, IL
National Provider Identifier
1477531879
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 036-086668
- Practice address
- 518 Lucinda Avenue
Health Services, Northern Illinois University
Dekalb, IL 60115-2828 - Phone
- (815) 753-1311
- Fax
- (815) 753-9599
- NPI assigned
- Jan 5, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 036-086668 | IL | Primary |
Addresses
Primary practice location
518 Lucinda Avenue
Health Services, Northern Illinois University
Dekalb, IL 60115-2828
Mailing address
518 Lucinda Avenue
Health Services, Northern Illinois University
Dekalb, IL 60115-2828
Phone (815) 753-1311
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180214001426 | IL | Order and Referring Only - General Practice | 9931469897 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-086668 | IL | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136419200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1391731200000",
"number": "1477531879",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "518 LUCINDA AVENUE",
"address_2": "HEALTH SERVICES, NORTHERN ILLINOIS UNIVERSITY",
"city": "DEKALB",
"state": "IL",
"postal_code": "601152828",
"telephone_number": "815-753-1311",
"fax_number": "815-753-9599"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "518 LUCINDA AVENUE",
"address_2": "HEALTH SERVICES, NORTHERN ILLINOIS UNIVERSITY",
"city": "DEKALB",
"state": "IL",
"postal_code": "601152828",
"telephone_number": "815-753-1311",
"fax_number": "815-753-9599"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAMERE",
"first_name": "BRIAN",
"middle_name": "DAVID",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-05",
"last_updated": "2014-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "IL",
"license": "036-086668",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dekalb, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.