Individual provider Active NPI

Lawrence C Stewart, MD

  • Ophthalmology Physician
  • Liverpool, NY
National Provider Identifier
1639254196
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
154663-0 Issued in NY
Practice address
5100 W Taft Rd
Suite 4M
Liverpool, NY 13088-3807
Phone
(315) 362-3937
Fax
(315) 458-7818
NPI assigned
Oct 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 154663-0 NY Primary

Addresses

Primary practice location

5100 W Taft Rd
Suite 4M
Liverpool, NY 13088-3807

Mailing address

5100 W Taft Rd
Suite 4M
Liverpool, NY 13088-3807
Phone (315) 362-3937

Other identifiers 2

IdentifierTypeStateIssuer
01025878MedicaidNY
154-663-9OtherNYWORKERS COMP

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
I20110620000274 NY Practitioner - Ophthalmology 7618041674 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
154663-0NYMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Surgeons of Central New York, PC Ophthalmology CurrentSince Jul 1, 1987 Accepting new patients
Ophthalmology Medical Service Group Inc Ophthalmology CurrentSince Feb 1, 2000 Accepting new patients

Locations

5100 W Taft Rd
Ste 4M
Liverpool, NY 13088
Phone (315) 362-3937

550 Harrison St
Ste 340
Syracuse, NY 13202
Phone (315) 464-5230

Organizations & group practices 2

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": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1639254196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 W TAFT RD",
            "address_2": "SUITE 4M",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130883807",
            "telephone_number": "315-362-3937",
            "fax_number": "315-458-7818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 W TAFT RD",
            "address_2": "SUITE 4M",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130883807",
            "telephone_number": "315-362-3937",
            "fax_number": "315-458-7818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "LAWRENCE",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "154663-0",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01025878",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKERS COMP",
            "identifier": "154-663-9",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Liverpool, NY

Sources for this page

Verify at the official NPI Registry.