Organization Active NPI

LCW PRS

  • Plastic Surgery Physician
  • Boca Raton, FL
National Provider Identifier
1659092906
Registry record updated Sep 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
Legal business name
LCW PRS
Practice address
5295 Town Center Rd Ste 402
Boca Raton, FL 33486-1080
Phone
(215) 206-9705
NPI assigned
Sep 6, 2022
Last updated
Sep 6, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2022

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

Authorized official

Name
Liza Wu, MDNPI 1942234018
Title
Owner
Phone
(215) 206-9705

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X NU Primary

Addresses

Primary practice location

5295 Town Center Rd Ste 402
Boca Raton, FL 33486-1080

Mailing address

2930 NW 26TH Ave
Boca Raton, FL 33434-3664
Phone (215) 206-9705

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL priveplastics.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220929001901 FL Part B Supplier - Clinic/Group Practice 8628454501 Receives reassigned benefits from 1 practitioner
Practice locations: Boca Raton, FL

National Provider Directory

National Provider Directory

Locations

5295 Town Center Rd
Ste 402
Boca Raton, FL 33486
Phone (215) 206-9705

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1662422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662422400000",
    "number": "1659092906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2930 NW 26TH AVE",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334343664",
            "telephone_number": "215-206-9705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5295 TOWN CENTER RD STE 402",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334861080",
            "telephone_number": "215-206-9705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LCW PRS",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-06",
        "last_updated": "2022-09-06",
        "certification_date": "2022-09-06",
        "status": "A",
        "authorized_official_last_name": "WU",
        "authorized_official_first_name": "LIZA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "215-206-9705",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "priveplastics.com",
            "affiliation": "N",
            "endpointDescription": "Office computers",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5295 Town Center Rd Ste 402",
            "city": "Boca Raton",
            "state": "FL",
            "country_code": "US",
            "postal_code": "334861080",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.