Active NPI
Lawrence Edward Lifson, MD
- Psychiatry Physician
- West Newton, MA
National Provider Identifier
1962540658
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 30111
- Practice address
- 22 Ellis Rd
West Newton, MA 02465 - Phone
- (617) 964-8809
- Fax
- (617) 244-7852
- NPI assigned
- Feb 2, 2007
- 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 30111 | MA | Primary |
Addresses
Primary practice location
22 Ellis Rd
West Newton, MA 02465
Mailing address
22 Ellis Rd
West Newton, MA 02465
Phone (617) 964-8809
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| B33358 | Other | MA | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20051021000528 | MA | Practitioner - Psychiatry | 6406872118 | Practice locations: West Newton, MA |
Care Compare profile
Medicare Care Compare- Specialty
- Psychiatry
- Education
- Tufts University School of Medicine, 1966
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
22 Ellis Rd
West Newton, MA 02465-2917
Phone (617) 964-8809
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30111 | MA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170374400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1962540658",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22 ELLIS RD",
"city": "WEST NEWTON",
"state": "MA",
"postal_code": "02465",
"telephone_number": "617-964-8809",
"fax_number": "617-244-7852"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22 ELLIS RD",
"city": "WEST NEWTON",
"state": "MA",
"postal_code": "02465",
"telephone_number": "617-964-8809",
"fax_number": "617-244-7852"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIFSON",
"first_name": "LAWRENCE",
"middle_name": "EDWARD",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MA",
"license": "30111",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "B33358",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in West Newton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.