Active NPI
Dale H Lawrence, PA
- Physician Assistant
- Schenectady, NY
National Provider Identifier
1922030816
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 003249-1
- Practice address
- 600 McClellan St
@ St. Clare'S Hospital ER Dept.
Schenectady, NY 12304-1009 - Phone
- (518) 383-5450
- Fax
- (518) 383-4223
- NPI assigned
- Jul 7, 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 003249-1 | NY | Primary |
Addresses
Primary practice location
600 McClellan St
@ St. Clare'S Hospital ER Dept.
Schenectady, NY 12304-1009
Mailing address
506 N Main St
Herkimer, NY 13350-1128
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02405190 | Medicaid | NY |
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
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 003249-1 | NY | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Provident Emergency Medicine Associates, PC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Emergency Medicine Physician
- Schenectady, NY
- NPI 1750310645
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1922030816",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "506 N MAIN ST",
"city": "HERKIMER",
"state": "NY",
"postal_code": "133501128"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 MCCLELLAN ST",
"address_2": "@ ST. CLARE'S HOSPITAL ER DEPT.",
"city": "SCHENECTADY",
"state": "NY",
"postal_code": "123041009",
"telephone_number": "518-383-5450",
"fax_number": "518-383-4223"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAWRENCE",
"first_name": "DALE",
"middle_name": "H",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-07",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "003249-1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02405190",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Schenectady, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.