William J Lackey MD PC

Primary specialty

Adult Reconstructive Orthopaedic Surgery PhysicianTaxonomy code 207XS0114X

Legal business name

WILLIAM J LACKEY MD PC

Practice address

153 W 27TH St Ste 1101
New York, NY 10001-6251

Phone

(917) 275-2241

NPI assigned

Sep 26, 2018

Organization subpart

No

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

Authorized official

Name

Mrs. Elizabeth Gofayzen

Title

Billing Manager

Phone

(845) 450-0214

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• William James Lackey Jr., M.D.

  • Adult Reconstructive Orthopaedic Surgery Physician
  • Brooklyn, NY
  • NPI 1912014218
  Medicare reassignment NPD

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

{
    "created_epoch": "1537920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1537920000000",
    "number": "1760967723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "153 W 27TH ST STE 11011000",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100016203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "153 W 27TH ST STE 1101",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100016251",
            "telephone_number": "917-275-2241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM J LACKEY MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-26",
        "last_updated": "2018-09-26",
        "status": "A",
        "authorized_official_last_name": "GOFAYZEN",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "845-450-0214",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207XS0114X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Reconstructive Orthopaedic Surgery Physician in New York, NY
• Providers in New York, NY by specialty
• Adult Reconstructive Orthopaedic Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2018; 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.