Active NPI
Lawrence J Israel, MD
- Diagnostic Radiology Physician
- Woodbridge, VA
National Provider Identifier
1821088345
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 0101046305
- Practice address
- 2300 Opitz Blvd
Woodbridge, VA 22191-3311 - Phone
- (703) 670-1561
- Fax
- (703) 670-4961
- NPI assigned
- Oct 26, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 0101046305 | VA | Primary |
Addresses
Primary practice location
2300 Opitz Blvd
Woodbridge, VA 22191-3311
Mailing address
1201 Seven Locks Rd
Suite 200
Rockville, MD 20854-2931
Phone (301) 652-5771
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7200293 | Medicaid | VA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101046305 | VA | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Potomac Radiology & Imaging Associates Inc | Diagnostic Radiology | Past | Accepting new patients |
| Pediatrix Medical Group of the Mid-Atlantic PC | Past | Accepting new patients |
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.
-
- Diagnostic Radiology Physician
- Woodbridge, VA
- NPI 1508838624
-
- Maternal & Fetal Medicine Physician
- Rockville, MD
- NPI 1205859691
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130284800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193961600000",
"number": "1821088345",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1201 SEVEN LOCKS RD",
"address_2": "SUITE 200",
"city": "ROCKVILLE",
"state": "MD",
"postal_code": "208542931",
"telephone_number": "301-652-5771",
"fax_number": "301-652-6332"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2300 OPITZ BLVD",
"city": "WOODBRIDGE",
"state": "VA",
"postal_code": "221913311",
"telephone_number": "703-670-1561",
"fax_number": "703-670-4961"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ISRAEL",
"first_name": "LAWRENCE",
"middle_name": "J",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-26",
"last_updated": "2007-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "VA",
"license": "0101046305",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7200293",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Woodbridge, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.