Active NPI
Lawrence Broxmeyer, M.D.
- Internal Medicine Physician
- Bayside, NY
National Provider Identifier
1831375922
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- MD028175-E
- Practice address
- 20811 Estates Dr
Bayside, NY 11360-1167 - Phone
- (718) 229-3694
- NPI assigned
- Jan 18, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 027388-1 | NY | |
| Pharmacist | 183500000X | RP-045854-R | PA | |
| Internal Medicine Physician | 207R00000X | MD028175-E | PA | Primary |
Addresses
Primary practice location
20811 Estates Dr
Bayside, NY 11360-1167
Mailing address
20811 Estates Dr
Bayside, NY 11360-1167
Phone (718) 229-3694
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 027388-1 | NY | MD | Pharmacist |
| RP-045854-R | PA | MD | Pharmacist |
| MD028175-E | PA | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1200614400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1200614400000",
"number": "1831375922",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20811 ESTATES DR",
"city": "BAYSIDE",
"state": "NY",
"postal_code": "113601167",
"telephone_number": "718-229-3694"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20811 ESTATES DR",
"city": "BAYSIDE",
"state": "NY",
"postal_code": "113601167",
"telephone_number": "718-229-3694"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROXMEYER",
"first_name": "LAWRENCE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-01-18",
"last_updated": "2008-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "027388-1",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PA",
"license": "RP-045854-R",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "PA",
"license": "MD028175-E",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bayside, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.