Laurel Medical Group, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

C1-0005393 Issued in DE

Legal business name

LAUREL MEDICAL GROUP, LLC

Practice address

1124 S Central Ave
Laurel, DE 19956-1418

Phone

(302) 875-7753

NPI assigned

Oct 9, 2006

Last updated

Sep 11, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Antonio Pedro, M.D.NPI 1922192434

Title

Co-Owner

Phone

(302) 875-7753

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in DE

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Antonio Pedro, M.D.

  • Nephrology Physician
  • Laurel, DE
  • NPI 1922192434
  Medicare reassignment Care Compare group NPD Authorized official
• Odilon Claravall, M.D.

  • Internal Medicine Physician
  • Laurel, DE
  • NPI 1093800401
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1160352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1477640696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 RIVERS END DR",
            "city": "SEAFORD",
            "state": "DE",
            "postal_code": "199738011",
            "telephone_number": "302-628-3018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1124 S CENTRAL AVE",
            "city": "LAUREL",
            "state": "DE",
            "postal_code": "199561418",
            "telephone_number": "302-875-7753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAUREL MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-09",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "PEDRO",
        "authorized_official_first_name": "ANTONIO",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "302-875-7753",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "DE",
            "license": "C1-0005393",
            "primary": true
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "DE",
            "license": "C1-0004999",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lakeside Physical Therapy, LLC
• Naomi Lang
• Laurel Fire Department Inc.
• Laurel Health Services Inc
• Laurel Health Services Inc (Express Pharmacy)
• Laurel Senior Center, Inc.
• Tracy Lynn Lewis, RN
• Living Alive Home Health Agency
• Diane H Lubkeman, M.D.
• M Cristina Machin

• Internal Medicine Physician in Laurel, DE
• Providers in Laurel, DE by specialty
• Internal Medicine Physician in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.