Individual provider Active NPI

Lawrence J Wasser, M.D.

  • Pediatrics Physician
  • Louisville, KY
National Provider Identifier
1689650061
Registry record updated Sep 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
20466 Issued in KY
Practice address
231 E Chestnut St
Louisville, KY 40202-1821
Phone
(502) 629-6000
Fax
(502) 852-4989
NPI assigned
Dec 19, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20466 KY
Pediatrics Physician 208000000X 20466 KY Primary

Addresses

Primary practice location

231 E Chestnut St
Louisville, KY 40202-1821

Mailing address

PO Box 909
Louisville, KY 40201-0909
Phone (502) 629-6000

Other identifiers 2

IdentifierTypeStateIssuer
100463670MedicaidIN
64204662MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20051215000342 KY Practitioner - Pediatric Medicine 8426949348 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20466KYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Louisville Physicians, Inc. Family Medicine Current Accepting new patients
Norton Children's Medical Group, LLC CurrentSince Feb 1, 2020 Accepting new patients
Norton Children's Medical Group, LLC CurrentSince Feb 1, 2020 Accepting new patients
Norton Children's Medical Group, LLC Current Accepting new patients
University of Louisville Physicians, Inc. CurrentSince Sep 1, 2012 Accepting new patients
University of Louisville Physicians, Inc. CurrentSince Sep 1, 2012 Accepting new patients

Locations

7752 Solution Ctr
Chicago, IL 60677

601 S Floyd St
Ste 604
Louisville, KY 40202
Phone (502) 559-1670

231 E Chestnut St
Louisville, KY 40202
Phone (502) 852-8500

571 S Floyd St
Louisville, KY 40202
Phone (502) 561-2700

530 S Jackson St
Louisville, KY 40202
Phone (502) 562-3000

Organizations & group practices 6

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": "1134950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409875200000",
    "number": "1689650061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 909",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402010909",
            "telephone_number": "502-629-6000",
            "fax_number": "502-852-4989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "231 E CHESTNUT ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021821",
            "telephone_number": "502-629-6000",
            "fax_number": "502-852-4989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASSER",
        "first_name": "LAWRENCE",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-19",
        "last_updated": "2014-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "20466",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KY",
            "license": "20466",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100463670",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64204662",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.