MEDICARE: DR. LAWRENCE EDWARD MCGINNESS D.P.M.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0103X	Foot & Ankle Surgery Podiatrist	1520	MA
2	213ES0000X	Sports Medicine Podiatrist	1520	MA
3	213ES0131X	Foot Surgery Podiatrist	1520	MA
4	213E00000X	Podiatrist	1520	MA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
8	480000403	OTHER	MA	RETIRED RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	123338	OTHER	MA	JOHN HANCOCK
2	72664	OTHER	MA	AETNA / US HEALTHCARE
3	001520	OTHER	MA	TUFTS HEALTH PLAN
4	0128464	OTHER	MA	CIGNA
5	S018387	OTHER	MA	CHAMPUS
6	27-00015	OTHER	MA	UNITED HEALTHCARE
7	32620	OTHER	MA	FALLON COMMUNITY HEALTH
9	Y70654	OTHER	MA	BLUE CROSS BLUE SHIELD
10	458130	OTHER	MA	CIGNA HEALTHSOURCE
11	33588	OTHER	MA	HARVARD PILGRIM HEALTH CA

General Provider Information

NPI Number	:	1548245699
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAWRENCE EDWARD MCGINNESS D.P.M.

Provider Business Mailing Address
First Line	:	900 CUMMINGS CTR
Second Line	:	STE 309V
City	:	BEVERLY
State	:	MA
Zip	:	01915-6181
Country	:	US
Telephone Number	:	978-922-0288
Fax Number	:	978-927-6265

Provider Business Practice Location Address
First Line	:	900 CUMMINGS CTR
Second Line	:	SUITE 119-W
City	:	BEVERLY
State	:	MA
Zip	:	01915-6198
Country	:	US
Telephone Number	:	978-922-0288
Fax Number	:	978-927-6265

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/13/2005
Last Update Date	:	09/12/2019

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