Individual provider Active NPI

Harrison Joseph Lave

  • Surgical Physician Assistant
  • Valley Stream, NY
National Provider Identifier
1922625870
Registry record updated Jun 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
025067 Issued in NY
Practice address
133 E Merrick Rd
Valley Stream, NY 11580-5900
Phone
(516) 887-5500
NPI assigned
Jun 26, 2020
Last updated
Jun 26, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 025067 NY Primary

Addresses

Primary practice location

133 E Merrick Rd
Valley Stream, NY 11580-5900

Mailing address

16 Blacksmith Rd
Levittown, NY 11756-3106
Phone (828) 289-2012

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20201026002812 NY Practitioner - Physician Assistant 7517387863 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Orthopedics and Joint Preservation PCGroup PAC ID 6103077961, 4 clinicians

Practice addresses (Care Compare)

133 E Merrick Rd
Valley Stream, NY 11580-5900
Phone (516) 887-5500

141 E Merrick Rd
Valley Stream, NY 11580-5925
Phone (516) 887-5500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
025067NYMDPharmacist

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1593129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593129600000",
    "number": "1922625870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 BLACKSMITH RD",
            "city": "LEVITTOWN",
            "state": "NY",
            "postal_code": "117563106",
            "telephone_number": "828-289-2012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 E MERRICK RD",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115805900",
            "telephone_number": "516-887-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAVE",
        "first_name": "HARRISON",
        "middle_name": "JOSEPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-26",
        "last_updated": "2020-06-26",
        "certification_date": "2020-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "025067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Stream, NY

Sources for this page

Verify at the official NPI Registry.