Provider Demographics
NPI:1407136112
Name:LAWRENCE E. MCGINNESS, D.P.M., PC
Entity type:Organization
Organization Name:LAWRENCE E. MCGINNESS, D.P.M., PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:MCGINNESS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:978-922-0288
Mailing Address - Street 1:900 CUMMINGS CTR
Mailing Address - Street 2:SUITE 119-W
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-6198
Mailing Address - Country:US
Mailing Address - Phone:978-922-0288
Mailing Address - Fax:978-927-6265
Practice Address - Street 1:900 CUMMINGS CTR
Practice Address - Street 2:SUITE 119-W
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-6198
Practice Address - Country:US
Practice Address - Phone:978-922-0288
Practice Address - Fax:978-927-6265
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-25
Last Update Date:2011-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1520213E00000X, 213EP1101X, 213ES0000X, 213ES0103X, 213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
No213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Single Specialty
No213ES0000XPodiatric Medicine & Surgery Service ProvidersPodiatristSports MedicineGroup - Single Specialty
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA12338OtherJOHN HANCOCK
MA27-00015OtherUNITED HEALTHCARE
MA33588OtherHARVARD PILGRIM HEALTH CARE
MA458130OtherCIGNA HEALTHSOURCE
MAS018387OtherCHAMPUS
MA4407434OtherAETNA
MA480000403OtherRETIRED RAILROAD MEDICARE
MA128464OtherCIGNA
MA32620OtherFALLON COMMUNITY HEALTH CARE
MA72664OtherAETNA / US HEALTHCARE
MAY70654OtherBLUE CROSS BLUE SHIELD
MA001520OtherTUFTS HEALTH PLAN
MA33588OtherHARVARD PILGRIM HEALTH CARE
MAT58706Medicare UPIN