Active NPI
Lawrence Neil Tanenbaum, M.D.
- Diagnostic Radiology Physician
- New York, NY
National Provider Identifier
1851371272
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 25MA05320100
- Practice address
- 1176 5TH Ave
New York, NY 10029-6503 - Phone
- (212) 241-8426
- NPI assigned
- Jan 20, 2006
- 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 | 25MA05320100 | NJ | Primary |
Addresses
Primary practice location
1176 5TH Ave
New York, NY 10029-6503
Mailing address
1176 5TH Ave
New York, NY 10029-6503
Phone (212) 241-8426
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0414000 | Medicaid | NJ |
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 |
|---|---|---|---|
| 25MA05320100 | NJ | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Edison Radiology Group PA JFK Medical Center | Diagnostic Radiology | Past | Accepting new patients |
| Icahn School of Medicine at Mount Sinai | Past | Accepting new patients | |
| Edison Imaging Associates, PA | Past | Accepting new patients | |
| Inner Imaging, PC | Past | Accepting new patients | |
| Open MRI of Perth Amboy, LLC | Diagnostic Radiology | Past | Accepting new patients |
Interoperability endpoints
- ltanenbaum@hiemail.healtheconnections.org
Organizations & group practices 5
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.
-
- Specialty Pharmacy
- New York, NY
- NPI 1629410816
-
- Nuclear Cardiology Physician
- New York, NY
- NPI 1780806307
-
- Specialist
- Old Bridge, NJ
- NPI 1790811016
-
- Diagnostic Radiology Physician
- Edison, NJ
- NPI 1417013731
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137715200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320364800000",
"number": "1851371272",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1176 5TH AVE",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100296503",
"telephone_number": "212-241-8426"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1176 5TH AVE",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100296503",
"telephone_number": "212-241-8426"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TANENBAUM",
"first_name": "LAWRENCE",
"middle_name": "NEIL",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-20",
"last_updated": "2011-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "NJ",
"license": "25MA05320100",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0414000",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.