Michael Joesph Lackner, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

014415-1 Issued in NY

Practice address

535 E 70TH St
New York, NY 10021-4823

Phone

(212) 774-2837

Fax

(646) 797-8428

NPI assigned

Nov 10, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 3

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H1722

Interoperability endpoints

• FHIR API: https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/DSTU2
• FHIR API: https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/R4/
• Direct secure messaging: mlackner7569@direct.hss.edu

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.

• Jamaica Hospital

  • Emergency Medical Services (Emergency Medicine) Physician
  • Jamaica, NY
  • NPI 1477505220
  Medicare reassignment NPD
• Ny Society for the Relief of Ruptured & Crippled Maintaining

  • Orthopaedic Surgery Physician
  • New York, NY
  • NPI 1902243488
  Medicare reassignment NPD
• White Plains Physician Services PC

  • Internal Medicine Physician
  • White Plains, NY
  • NPI 1124502687
  Medicare reassignment NPD
• Yonkers Spine Medicine PLLC

  • Pain Medicine Physician
  • Yonkers, NY
  • NPI 1275167082
  NPD Authorized official
• Bronxcare Health System

  • Internal Medicine Physician
  • Bronx, NY
  • NPI 1245390855
  Medicare reassignment
• Coney Island Medical Practice Plan, P.C.

  • General Practice Physician
  • Brooklyn, NY
  • NPI 1386951762
  Medicare reassignment
• East Post Road Medical Services PC

  • Emergency Medicine Physician
  • White Plains, NY
  • NPI 1841767274
  Medicare reassignment
• Lawrence Medical Associates, PC

  • Internal Medicine Physician
  • Yorktown Heights, NY
  • NPI 1023257441
  Medicare reassignment
• Bronxcare Health System

  • Neurological Surgery Physician
  • Bronx, NY
  • NPI 1578613782
  NPD
• Bronxcare Health System

  • Methadone Clinic
  • Bronx, NY
  • NPI 1801428222
  NPD
• Jamaica Hospital

  • Skilled Nursing Facility
  • Jamaica, NY
  • NPI 1750516795
  NPD
• Lawrence Medical Associates, PC

  • Multi-Specialty Clinic/Center
  • Yorktown Heights, NY
  • NPI 1184115479
  NPD

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

{
    "created_epoch": "1289347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617926400000",
    "number": "1912208752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 29234",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100874923",
            "telephone_number": "631-329-6925",
            "fax_number": "631-329-6951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 E 70TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100214823",
            "telephone_number": "212-774-2837",
            "fax_number": "646-797-8428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACKNER",
        "first_name": "MICHAEL",
        "middle_name": "JOESPH",
        "name_prefix": "Mr.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-11-10",
        "last_updated": "2021-04-09",
        "certification_date": "2021-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "014415-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03328470",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mlackner7569@direct.HSS.edu",
            "affiliation": "N",
            "endpointDescription": "Hospital Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "535 E 70th St",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100214823",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/R4/",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "535 E 70th St",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100214823",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/DSTU2",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "535 E 70th St",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100214823",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Susan Lacina, CNP
• Carolyn Rebecca Lack, DPT
• Judyta Otylia Lacka, MS
• Bryan Lackey, PMHNP-BC
• Roy S Lackey, MD
• Jacob Lackow, M.A.
• Juliette Rose Lackow, LMSW
• Rachel Stephanie Lacks, ED.M.
• Noah Laclair
• Jessica B Lacorte, AUD

• Physician Assistant in New York, NY
• Providers in New York, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.