Individual provider Active NPI

Lawrence C. Stabile, DPM

  • Podiatrist
  • Paterson, NJ
National Provider Identifier
1952357121
Registry record updated Oct 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
25MD00236400 Issued in NJ
Practice address
21 Mill St
Suite 3
Paterson, NJ 07501-1886
Phone
(973) 881-1115
Fax
(973) 881-8686
NPI assigned
May 26, 2006
Last updated
Oct 17, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 25MD00236400 NJ Primary

Addresses

Primary practice location

21 Mill St
Suite 3
Paterson, NJ 07501-1886

Mailing address

21 Mill St
Suite 3
Paterson, NJ 07501-1886
Phone (973) 881-1115

Other identifiers 1

IdentifierTypeStateIssuer
7006501MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100209000069 NJ Practitioner - Podiatry 8426191776 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Paterson Division of HealthGroup PAC ID 0446280663, 2 clinicians

Practice addresses (Care Compare)

176 Broadway
Paterson, NJ 07505-1115
Phone 97332112772739

21 Mill St
Suite 3
Paterson, NJ 07501-1886
Phone (973) 881-1115

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Great Falls Foot & Ankle Center, P.a. Podiatrist CurrentSince Oct 23, 1996 Accepting new patients
Park Dental New Jersey PC PastSince Oct 23, 1996 Accepting new patients
Paterson Division of Health PastSince Jun 4, 2020 Accepting new patients

Locations

21 Mill St
Ste 3
Paterson, NJ 07501
Phone (973) 742-7275

Organizations & group practices 4

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": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224201600000",
    "number": "1952357121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 MILL ST",
            "address_2": "SUITE 3",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075011886",
            "telephone_number": "973-881-1115",
            "fax_number": "973-881-8686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 MILL ST",
            "address_2": "SUITE 3",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075011886",
            "telephone_number": "973-881-1115",
            "fax_number": "973-881-8686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STABILE",
        "first_name": "LAWRENCE",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-26",
        "last_updated": "2008-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NJ",
            "license": "25MD00236400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7006501",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Paterson, NJ

Sources for this page

Verify at the official NPI Registry.