DR. DAVID LAWLOR MD
NPI 1295711323
Surgery - Pediatric Surgery in Boston, MA

NPI Status: Active since December 20, 2005

Contact Information

55 FRUIT ST
PEDIATRIC SURGERY WRN 11
BOSTON, MA
ZIP 02114
Phone: (617) 726-8858
Fax: (617) 726-2167

NPI Profile Information
Primary Taxonomy
Secondary Taxonomies
Insurance Plans Accepted
Secondary Locations
Medicare Participation & PECOS Status
Durable Medical Equipment
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Male
Years of Experience 39
Surgery
Pediatric Surgery
Accepts Insurance
Accepts Medicare Approved Payment
PECOS Enrolled

About DAVID LAWLOR

This page provides the complete NPI Profile along with additional information for David Lawlor, a provider established in Boston, Massachusetts with a medical specialization in Surgery, focusing in pediatric surgery and more than 39 years of experience. He graduated from Geisel School Of Medicine At Dartmouth in 1987. The healthcare provider is registered in the NPI registry with number 1295711323 assigned on December 2005. The practitioner's primary taxonomy code is 2086S0120X with license number 74011 (MA). The provider is registered as an individual and his NPI record was last updated 2 years ago.

NPI: 1295711323
Provider Name: DR. DAVID LAWLOR MD
Gender: Male
Entity Type: Individual
Location Address: 55 FRUIT ST PEDIATRIC SURGERY WRN 11 BOSTON, MA 02114
Location Phone: (617) 726-8858
Location Fax: (617) 726-2167
Mailing Address: PO BOX 9142 MASS GENERAL PHYSICIAN ORGANIZATION CHARLESTOWN, MA 02129
Mailing Phone: (617) 726-8858
Mailing Fax: (617) 726-2167
Medical School Name: GEISEL SCHOOL OF MEDICINE AT DARTMOUTH
Graduation Year: 1987
Is Sole Proprietor?: Yes
Enumeration Date: 12-20-2005
Last Update Date: 12-11-2024
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Location Map

Secondary Locations

202 Conway Dr Ste 200
Kalispell, MT 59901
(406) 758-7490

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification: Surgery Pediatric Surgery
Taxonomy Code: 2086S0120X
Type: Allopathic & Osteopathic Physicians
License No.: 74011
License State: MA
Taxonomy Description: A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No.	Taxonomy Code	Type	Classification / Specialization	License No. (State)
1	208600000X	Allopathic & Osteopathic Physicians	Surgery	74011 (MA)
2	2086S0120X	Allopathic & Osteopathic Physicians	Surgery Pediatric Surgery	74015 (MT)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Anthem Blue Cross and Blue Sheld

Anthem Bronze Preferred Blue PPO 6000/20%/8000 w/HSA - PPO
Anthem Bronze Preferred Blue PPO 7000/50%/8000 w/HSA - PPO
Anthem Bronze Preferred Blue PPO 7500/30%/10000 Value - PPO
Anthem Bronze Preferred Blue PPO 8500/50%/9200 - PPO
Anthem Gold Preferred Blue PPO 1000/20%/7500 - PPO
Anthem Gold Preferred Blue PPO 2000/0%/6500 RxD - PPO
Anthem Gold Preferred Blue PPO 2000/10%/4600 w/HSA - PPO
Anthem Gold Preferred Blue PPO 2000/10%/7500 - PPO
Anthem Gold Preferred Blue PPO 2000/20%/4600 w/HSA - PPO
Anthem Gold Preferred Blue PPO 3000/0%/7500 RxD - PPO
Anthem Gold Preferred Blue PPO 500/30%/9000 - PPO
Anthem Platinum Preferred Blue PPO 250/10%/3500 - PPO
Anthem Silver Preferred Blue PPO 2500/30%/10000 Value - PPO
Anthem Silver Preferred Blue PPO 3000/30%/9000 Value - PPO
Anthem Silver Preferred Blue PPO 3500/20%/10000 - PPO
Anthem Silver Preferred Blue PPO 3500/20%/7250 w/HSA - PPO
Anthem Silver Preferred Blue PPO 4000/0%/9000 - PPO
Anthem Silver Preferred Blue PPO 4000/0%/9000 RxD - PPO
Anthem Silver Preferred Blue PPO 4000/10%/7250 w/HSA - PPO
Anthem Silver Preferred Blue PPO 4000/20%/8500 - PPO

Anthem Blue Cross and Blue Shield

Anthem Bronze Pathway X Enhanced 6000/35% HSA - HMO
Anthem Bronze Pathway X Enhanced 7000/0% ($0 Virtual PCP + $0 Select Drugs) - HMO
Anthem Bronze Pathway X Enhanced 7500/50% ($0 Virtual PCP + $0 Select Drugs) Standard - HMO
Anthem Catastrophic Pathway X Enhanced - HMO
Anthem Gold Pathway X Enhanced 1200/20% ($0 Virtual PCP + $0 Select Drugs) - HMO
Anthem Gold Pathway X Enhanced 2000/25% ($0 Virtual PCP + $0 Select Drug) Standard - HMO
Anthem Gold Pathway X Enhanced 700/40% ($0 Virtual PCP + $0 Select Drugs) - HMO
Anthem Heart Healthy Bronze Pathway X Enhanced 6000/40% ($0 Virtual PCP + $0 Select Drugs) - HMO
Anthem Heart Healthy Silver Pathway X Enhanced 4000/0% ($0 Virtual PCP + $0 Select Drugs) - HMO
Anthem Silver Pathway X Enhanced 4500/20% HSA - HMO
Anthem Silver Pathway X Enhanced 5500/20% ($0 Virtual PCP + $0 Select Drugs) - HMO
Anthem Silver Pathway X Enhanced 6000/40% ($0 Virtual PCP + $0 Select Drugs) Standard - HMO
Anthem Bronze Access Blue New England HMO 6000/20%/8000 w/HSA - HMO
Anthem Bronze Access Blue New England HMO 7000/50%/8000 w/HSA - HMO
Anthem Bronze Access Blue New England HMO 7500/30%/10000 Value - HMO
Anthem Bronze Access Blue New England HMO 8500/50%/9200 - HMO
Anthem Bronze Pathway X HMO 6000/20%/8000 w/HSA - HMO
Anthem Bronze Pathway X HMO 7000/50%/8000 w/HSA - HMO
Anthem Bronze Pathway X HMO 7500/30%/10000 Value - HMO
Anthem Bronze Pathway X HMO 8500/50%/9200 - HMO

Blue Cross and Blue Shield of Montana

Blue Focus Bronze POS? 205 - POS
Blue Focus Bronze POS? 705 - POS
Blue Focus Bronze POS? Standard - POS
Blue Focus Gold POS? 207 - POS
Blue Focus Gold POS? 902 - POS
Blue Focus Gold POS? Standard - POS
Blue Focus Silver POS? 206 - POS
Blue Focus Silver POS? 903 - POS
Blue Focus Silver POS? Standard - POS
Blue Preferred Bronze PPO? 201 - PPO
Blue Preferred Bronze PPO? 202 - PPO
Blue Preferred Bronze PPO? Standard - PPO
Blue Preferred Gold PPO? 204 - PPO
Blue Preferred Gold PPO? 901 - PPO
Blue Preferred Gold PPO? Standard - PPO
Blue Preferred Security PPO? 200 - PPO
Blue Preferred Silver PPO? 203 - PPO
Blue Preferred Silver PPO? 308 - PPO
Blue Preferred Silver PPO? Standard - PPO

Mountain Health CO-OP

Peak PPO Bronze HDHP - PPO
Peak PPO Bronze Standard - PPO
Peak PPO Catastrophic - PPO
Peak PPO Gold - PPO
Peak PPO Gold Standard - PPO
Peak PPO Silver - PPO
Peak PPO Silver Standard - PPO
Plus Bronze - PPO
Plus Bronze Standard - PPO
Plus Gold - PPO
Plus Gold Standard - PPO
Plus Silver Standard - PPO
PEAK PPO BRONZE - PPO
PEAK PPO BRONZE HDHP - PPO
PEAK PPO GOLD - PPO
PEAK PPO GOLD HDHP - PPO
PEAK PPO SILVER - PPO
PEAK PPO SILVER HDHP - PPO
Plus Bronze HDHP - PPO
Plus Gold HDHP - PPO

Providence Health Plan

HSA Qualified 7500 Bronze - Choice Network - EPO
HSA-E Qualified 7500 Bronze - Signature Network - EPO
Providence Oregon Standard Bronze Plan - Choice Network - EPO
Providence Oregon Standard Bronze Plan - Signature Network - EPO
Providence Oregon Standard Gold Plan - Choice Network - EPO
Providence Oregon Standard Gold Plan - Signature Network - EPO
Providence Oregon Standard Silver Plan - Choice Network - EPO
Providence Oregon Standard Silver Plan - Signature Network - EPO

WellSense Health Plan

WellSense Clarity NH Bronze 6500 HSA + $0 Rx List + 24/7 Nurse Advice - HMO
WellSense Clarity NH Bronze 7500 HSA + $0 Rx List + 24/7 Nurse Advice - HMO
WellSense Clarity NH Bronze 7600 HSA + $0 Rx List + 24/7 Nurse Advice - HMO
WellSense Clarity NH Gold 2000 + $0 Rx List + 24/7 Nurse Advice - HMO
WellSense Clarity NH Silver 0 Deductible + $0 Rx List + 24/7 Nurse Advice - HMO
WellSense Clarity NH Silver 3400 + $0 Rx List + 24/7 Nurse Advice - HMO
WellSense Clarity NH Silver 6000 + $0 Rx List + 24/7 Nurse Advice - HMO

Blue Cross Blue Shield

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Medicare

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Medicaid

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Tufts Health Plan

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier	Type / Code	Identifier State	Identifier Issuer
J22667	OTHER (01)	MA	BCBS MA
0101524	MEDICAID (05)	MA
074011	OTHER (01)	MA	TUFTS HEALTH PLAN

Medicare Participation & PECOS Enrollment Status

David Lawlor is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

David Lawlor is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

Is the provider registered in PECOS? Yes
PECOS PAC ID: 8224061114
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.
PECOS Enrollment ID: I20050912000981
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.
Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Orthotic Devices

DME-Orthotic Devices (DF010N)
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each (HCPCS:A4385)
1 DME suppliers used 12 Medicare Claims 240 Services Paid
DME-Orthotic Devices (DF010N)
Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce (HCPCS:A4394)
1 DME suppliers used 12 Medicare Claims 288 Services Paid
DME-Orthotic Devices (DF010N)
Ostomy skin barrier, pectin-based, paste, per ounce (HCPCS:A4406)
1 DME suppliers used 12 Medicare Claims 48 Services Paid
DME-Orthotic Devices (DF010N)
Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each (HCPCS:A4407)
1 DME suppliers used 12 Medicare Claims 240 Services Paid
DME-Orthotic Devices (DF010N)
Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each (HCPCS:A4425)
1 DME suppliers used 12 Medicare Claims 240 Services Paid
DME-Orthotic Devices (DF010N)
Skin barrier, wipes or swabs, each (HCPCS:A5120)
1 DME suppliers used 12 Medicare Claims 300 Services Paid

Durable Medical Equipment

DME-Medical/Surgical Supplies (DA000N)
Adhesive remover, wipes, any type, each (HCPCS:A4456)
1 DME suppliers used 12 Medicare Claims 600 Services Paid

NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1295711323, we treat the final digit (3) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 57. The final step is to find the difference between that total and the next multiple of ten (60 - 57 = 3).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1

Doubled → 2

Pos 2

Unchanged

Pos 3

Doubled → 18 → 1 + 8

Pos 4

Unchanged

Pos 5

Doubled → 14 → 1 + 4

Pos 6

Unchanged

Pos 7

Doubled → 2

Pos 8

Unchanged

Pos 9

Doubled → 4

Check

Target digit

Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 9 → 18 → 9 7 → 14 → 5 1 → 2 2 → 4