NPIMap

Organization Active NPI

Laurelton Medical Physicians PLLC

Doing business as Laurelton Medical Center

  • Clinic/Center
  • Laurelton, NY
National Provider Identifier
1902216229
Registry record updated Jan 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
178587 Issued in NY
Legal business name
LAURELTON MEDICAL PHYSICIANS PLLC
Doing business as
Laurelton Medical Center
Practice address
22414 Merrick Blvd
Laurelton, NY 11413-2023
Phone
(718) 949-6433
Fax
(718) 949-0331
NPI assigned
May 8, 2014
Last updated
Jan 15, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2026

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

Authorized official

Name
Richard Watson, MDNPI 1962472886
Title
Owner
Phone
(718) 949-6433

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 178587 NY Primary
Medical Specialty Clinic/Center 261QM2500X 178587 NY

Addresses

Primary practice location

22414 Merrick Blvd
Laurelton, NY 11413-2023

Mailing address

22414 Merrick Blvd
Laurelton, NY 11413-2023
Phone (718) 949-6433

Other names 1

  • Laurelton Medical Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20141103000364 NY Part B Supplier - Clinic/Group Practice 2860613049 Receives reassigned benefits from 6 practitioners
Practice locations: Laurelton, NY
O20260126000188 NY Part B Supplier - Clinic/Group Practice 9537646179 Receives reassigned benefits from 7 practitioners
Practice locations: Laurelton, NY

National Provider Directory

National Provider Directory

Locations

22414 Merrick Blvd
Ste B
Laurelton, NY 11413
Phone (718) 949-6433

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1399507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768435200000",
    "number": "1902216229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22414 MERRICK BLVD",
            "city": "LAURELTON",
            "state": "NY",
            "postal_code": "114132023",
            "telephone_number": "718-949-6433",
            "fax_number": "718-949-0331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22414 MERRICK BLVD",
            "city": "LAURELTON",
            "state": "NY",
            "postal_code": "114132023",
            "telephone_number": "718-949-6433",
            "fax_number": "718-949-0331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAURELTON MEDICAL PHYSICIANS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-08",
        "last_updated": "2026-01-15",
        "certification_date": "2026-01-15",
        "status": "A",
        "authorized_official_last_name": "WATSON",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-949-6433",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NY",
            "license": "178587",
            "primary": true
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NY",
            "license": "178587",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Laurelton Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Laurelton, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2026; 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.