Individual provider Active NPI

Alan D Lavine, M.D.

  • Nephrology Physician
  • New York, NY
National Provider Identifier
1821489600
Registry record updated Feb 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
140013-1 Issued in NY
Practice address
80 Riverside Blvd Apt 16B
New York, NY 10069-0315
Phone
(212) 794-1742
Fax
(212) 794-1742
NPI assigned
Feb 14, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 14, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 140013-1 NY Primary

Addresses

Primary practice location

80 Riverside Blvd Apt 16B
New York, NY 10069-0315

Mailing address

80 Riverside Blvd Apt 16B
New York, NY 10069-0315
Phone (212) 794-1742

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
I20160401000527 NY Order and Referring Only - Internal MedicinePractitioner - NephrologyPractitioner - Internal Medicine 9133152721

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
140013-1NYMDNephrology Physician

NPI Registry JSON

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

{
    "created_epoch": "1423872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423872000000",
    "number": "1821489600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 RIVERSIDE BLVD APT 16B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100690315",
            "telephone_number": "212-794-1742",
            "fax_number": "212-794-1742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 RIVERSIDE BLVD APT 16B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100690315",
            "telephone_number": "212-794-1742",
            "fax_number": "212-794-1742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAVINE",
        "first_name": "ALAN",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-02-14",
        "last_updated": "2015-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "140013-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.