Individual provider Active NPI

Laura Vedder, D.O.

  • Pediatrics Physician
  • New York, NY
National Provider Identifier
1730311838
Registry record updated Sep 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
258728 Issued in NY
Practice address
254 W 87TH St
New York, NY 10024-2706
Phone
(212) 496-6440
Fax
(212) 496-1265
NPI assigned
Aug 23, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 258728 NY Primary

Addresses

Primary practice location

254 W 87TH St
New York, NY 10024-2706

Mailing address

254 W 87TH St
New York, NY 10024-2706
Phone (212) 496-6440

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
I20130711000157 NY Practitioner - Pediatric Medicine 7416197660 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore - Lij Medical PC CurrentSince Mar 21, 2018 Accepting new patients
North Shore-Lij Medical PC CurrentSince Mar 21, 2018 Accepting new patients

Locations

20014 44th Ave
Flushing, NY 11361
Phone (718) 224-3000

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

300 Community Dr
Fl 1
Manhasset, NY 11030
Phone (516) 562-2252

100 E 77th St
Fl 3
New York, NY 10075
Phone (212) 434-2900

300 Community Dr
Plandome, NY 11030

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: lvedder67881@northwell.direct-ci.com

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": "1250985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474934400000",
    "number": "1730311838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "254 W 87TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100242706",
            "telephone_number": "212-496-6440",
            "fax_number": "212-496-1265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "254 W 87TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100242706",
            "telephone_number": "212-496-6440",
            "fax_number": "212-496-1265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEDDER",
        "first_name": "LAURA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-23",
        "last_updated": "2016-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "258728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.