Individual provider Active NPI

Lawrence B Holzman, MD

  • Internal Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1720160625
Registry record updated Sep 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD035395E Issued in PA
Practice address
3400 Civic Center Blvd
Philadelphia, PA 19104-5127
Phone
(215) 662-2638
Fax
(215) 349-5703
NPI assigned
Oct 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD035395E PA Primary

Addresses

Primary practice location

3400 Civic Center Blvd
Philadelphia, PA 19104-5127

Mailing address

3400 Civic Center Blvd
Philadelphia, PA 19104-5127
Phone (215) 662-2638

Other identifiers 1

IdentifierTypeStateIssuer
2635527MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20091229000455 PA Practitioner - Internal MedicinePractitioner - Nephrology 8527108356 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Rutgers New Jersey Medical School, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of Penn-Medical GroupGroup PAC ID 6204730955, 3,433 clinicians

Practice addresses (Care Compare)

4126 Walnut St
Uphs Walnut Street Dialysis Clinic
Philadelphia, PA 19104-3511
Phone (215) 387-0500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD035395EPAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn - Medical Group Internal Medicine CurrentSince Nov 1, 2009 Accepting new patients
University of Penn-Medical Group CurrentSince Nov 1, 2009 Accepting new patients
University of Penn-Medical Group Current Accepting new patients
University of Penn - Medical Group Past Accepting new patients

Locations

3400 Convention Ave
Philadelphia, PA 19104
Phone (215) 662-2300

4126 Walnut St
Philadelphia, PA 19104
Phone (215) 387-0500

3400 Civic Center Blvd
Fl 1
Philadelphia, PA 19104
Phone (215) 615-5864

PO B0x 824320
Philadelphia, PA 19182

3701 Market St
Fl 1
Philadelphia, PA 19104
Phone (215) 662-2250

250 King of Prussia Rd
Radnor, PA 19087
Phone (610) 902-1800

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568332800000",
    "number": "1720160625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 CIVIC CENTER BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191045127",
            "telephone_number": "215-662-2638",
            "fax_number": "215-349-5703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 CIVIC CENTER BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191045127",
            "telephone_number": "215-662-2638",
            "fax_number": "215-349-5703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLZMAN",
        "first_name": "LAWRENCE",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2019-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD035395E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2635527",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.