Lawrence T Geoghegan, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

30208 Issued in MA

Practice address

77 Massachusetts Ave
Mit Medical Department E23-300
Cambridge, MA 02139-4301

Phone

(617) 253-4988

Fax

(617) 253-7265

NPI assigned

Oct 25, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Massachusetts Institute of Technology

  • Multi-Specialty Clinic/Center
  • Cambridge, MA
  • NPI 1346308723
  NPD (past)

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

{
    "created_epoch": "1130198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356652800000",
    "number": "1477543031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 MASSACHUSETTS AVE",
            "address_2": "MIT MEDICAL DEPARTMENT E23-300",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021394301",
            "telephone_number": "617-253-4988",
            "fax_number": "617-253-7265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 MASSACHUSETTS AVE",
            "address_2": "MIT MEDICAL DEPARTMENT E23-300",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021394301",
            "telephone_number": "617-253-4988",
            "fax_number": "617-253-7265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEOGHEGAN",
        "first_name": "LAWRENCE",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-25",
        "last_updated": "2012-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MA",
            "license": "30208",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0175161",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "B33229",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "LAM12968",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "030208",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Diane Gengo
• Gentle Minds Counseling
• Genzyme Corporation
• Geoffrey a White & Assoc. Inc.
• Geoffrey a. White & Assoc. Inc.
• Amy Beth George, LICSW
• Donna George, NP
• Gautam George, M.D.
• Marie Lourdes Georges, RN
• Susan Hazel Gere, MSW, PH.D.

• Surgery Physician in Cambridge, MA
• Providers in Cambridge, MA by specialty
• Surgery Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.