Individual provider Active NPI

Timothy Lau, PA-C

  • Physician Assistant
  • Flushing, NY
National Provider Identifier
1609504133
Registry record updated Aug 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
38-21 Main Street
Suite #1a
Flushing, NY 11354
Phone
(718) 888-1808
NPI assigned
Aug 11, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

38-21 Main Street
Suite #1a
Flushing, NY 11354

Mailing address

5811 8TH Ave # 2B
Brooklyn, NY 11220-3914
Phone (718) 772-5876

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250718002124 NY Practitioner - Physician Assistant 6608382478 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Modern Physician Services PCGroup PAC ID 6204140544, 55 clinicians

Practice addresses (Care Compare)

1169 Liberty Ave
Brooklyn, NY 11208-3308
Phone (646) 604-8180

436 Utica Ave
Brooklyn, NY 11213-5903
Phone (646) 604-8150

68 Graham Ave
Brooklyn, NY 11206-4017
Phone (646) 604-8130

916 Flatbush Ave
Brooklyn, NY 11226-4018
Phone (646) 604-8140

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
028693NYMDMassage Therapist

Organizations & group practices 1

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": "1660176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660176000000",
    "number": "1609504133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5811 8TH AVE # 2B",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112203914",
            "telephone_number": "718-772-5876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38-21 MAIN STREET",
            "address_2": "SUITE #1A",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "11354",
            "telephone_number": "718-888-1808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAU",
        "first_name": "TIMOTHY",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-08-11",
        "last_updated": "2022-08-11",
        "certification_date": "2022-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

Verify at the official NPI Registry.