Individual provider Active NPI

Nina Lau, MD

  • Pediatrics Physician
  • Elmhurst, NY
National Provider Identifier
1477591204
Registry record updated Mar 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
156389 Issued in NY
Practice address
88-31 55TH Avenue
Suite 201
Elmhurst, NY 11373-4686
Phone
(718) 899-6600
Fax
(718) 397-7782
NPI assigned
Jun 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2022

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 156389 NY Primary

Addresses

Primary practice location

88-31 55TH Avenue
Suite 201
Elmhurst, NY 11373-4686

Mailing address

55 Water Street
2ND Floor Cred Dept
New York, NY 10041-0004
Phone (646) 680-2888

Other practice location 1

96-10 Metropolitan Ave
Forest Hills, NY 11375-6625
Phone (718) 459-0400

Other identifiers 1

IdentifierTypeStateIssuer
01724010MedicaidNY

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
I20061108000481 NY Practitioner - Pediatric Medicine 1254338080 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Advantagecare Physicians PC CurrentSince Jan 26, 2017 Accepting new patients
Advantagecare Physicians PC CurrentSince Jan 26, 2017 Accepting new patients
Queens Long Island Medical Group, P.C. Pediatrics Past Accepting new patients

Locations

8831 55th Ave
#201
Elmhurst, NY 11373

8806 55th Ave
Flushing, NY 11373
Phone (718) 271-9730

9610 Metropolitan Ave
Forest Hills, NY 11375
Phone (718) 459-0400

55 Water St
Fl 2
New York, NY 10041

Interoperability endpoints

  • FHIR API: https://epwebapps.acpny.com/FHIRproxy/ACPNY/api/FHIR/R4

Organizations & group practices 3

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": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646265600000",
    "number": "1477591204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 WATER STREET",
            "address_2": "2ND FLOOR CRED DEPT",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100410004",
            "telephone_number": "646-680-2888",
            "fax_number": "516-542-5556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "88-31 55TH AVENUE",
            "address_2": "SUITE 201",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113734686",
            "telephone_number": "718-899-6600",
            "fax_number": "718-397-7782"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "96-10 Metropolitan Ave",
            "address_purpose": "LOCATION",
            "city": "Forest Hills",
            "state": "NY",
            "postal_code": "113756625",
            "country_code": "US",
            "telephone_number": "718-459-0400",
            "fax_number": "718-670-6479",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAU",
        "first_name": "NINA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-03",
        "last_updated": "2022-03-03",
        "certification_date": "2022-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "156389",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01724010",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, NY

Sources for this page

Verify at the official NPI Registry.