Organization Active NPI

Laurence D Landau DPM PC

  • Specialist
  • Bethpage, NY
National Provider Identifier
1932271368
Registry record updated Apr 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
N005051 Issued in NY
Legal business name
LAURENCE D LANDAU DPM PC
Practice address
4230 Hempstead Tpke Ste 200
Bethpage, NY 11714
Phone
(516) 233-1919
Fax
(516) 731-7302
NPI assigned
Nov 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2023

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

Authorized official

Name
Laurence LandauNPI 1750453940
Title
Sole Proprietor
Phone
(516) 233-1919

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
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X N005051 NY Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

4230 Hempstead Tpke Ste 200
Bethpage, NY 11714

Mailing address

PO Box 416
Bethpage, NY 11714-0416
Phone (516) 233-1919

Other identifiers 1

IdentifierTypeStateIssuer
01407767MedicaidNY

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100330001079 NY Part B Supplier - Clinic/Group Practice 4486780384 Receives reassigned benefits from 4 practitioners
Practice locations: Valley Stream, NY; Nesconset, NY; Massapequa, NY; Franklin Square, NY; Brooklyn, NY; Flushing, NY; Babylon, NY; Bronx, NY
O20150506000890 NY DME Supplier - Physician - Podiatry 4486780384 Practice locations: Massapequa, NY

National Provider Directory

National Provider Directory

Locations

160 Hicksville Rd
Bethpage, NY 11714
Phone (516) 731-1900

4230 Hempstead Tpke
Bethpage, NY 11714
Phone (516) 735-7900

4230 Hempstead Tpke
Ste 200
Bethpage, NY 11714
Phone (516) 656-1414

4333 Merrick Rd
Massapequa, NY 11758
Phone (516) 398-3836

125 Franklin Ave
Ste 204
Valley Stream, NY 11580
Phone (516) 872-0430

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682294400000",
    "number": "1932271368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 416",
            "city": "BETHPAGE",
            "state": "NY",
            "postal_code": "117140416",
            "telephone_number": "516-233-1919",
            "fax_number": "516-731-7302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4230 HEMPSTEAD TPKE STE 200",
            "city": "BETHPAGE",
            "state": "NY",
            "postal_code": "11714",
            "telephone_number": "516-233-1919",
            "fax_number": "516-731-7302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAURENCE D LANDAU DPM PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-14",
        "last_updated": "2023-04-24",
        "certification_date": "2023-04-24",
        "status": "A",
        "authorized_official_last_name": "LANDAU",
        "authorized_official_first_name": "LAURENCE",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "516-233-1919"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "N005051",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01407767",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethpage, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2023; 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.