Lawrence H Womack, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

223075 Issued in NY

Practice address

400 Montauk Hwy
Suite #111
West Islip, NY 11795-4429

Phone

(631) 277-0051

Fax

(631) 277-2690

NPI assigned

Jun 15, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 6

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1118793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222732800000",
    "number": "1487659629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 RAILROAD AVE # 205",
            "city": "BABYLON",
            "state": "NY",
            "postal_code": "117022204",
            "telephone_number": "631-277-0051",
            "fax_number": "631-277-2690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 MONTAUK HWY",
            "address_2": "SUITE #111",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117954429",
            "telephone_number": "631-277-0051",
            "fax_number": "631-277-2690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOMACK",
        "first_name": "LAWRENCE",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-15",
        "last_updated": "2008-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "223075",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA/US HEALTHCARE",
            "identifier": "3298766",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "421680216",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VYTRA HEALTHCARE",
            "identifier": "153114",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD HEALTH PLAN",
            "identifier": "P2912790",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02214588",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00165433",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daniel Mark Wilson Jr., RPA-C
• June Wisniewski
• Kim L. Wist, D.C.
• Stephanie Wohlberg, MS, OTR/L
• Womack Primary Medical Care, PLLC (Womack Internal Medicine, PLLC)
• Matthew Leon Woolley, MD
• Stefani T Wren, MD
• Divya Yadlapalli
• Zhanqing Yan, M.D.
• Mohammad Yazdanie, MD

• Internal Medicine Physician in West Islip, NY
• Providers in West Islip, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2008; 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.

Verify at the official NPI Registry.