Individual provider Active NPI

Lauren M Cabana, PA

  • Physician Assistant
  • Latham, NY
National Provider Identifier
1003190802
Registry record updated Oct 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
015172 Issued in NY
Practice address
1205 Troy Schenectady Rd Ste 101
Latham, NY 12110-1074
Phone
(518) 348-3176
NPI assigned
Sep 29, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 015172 NY Primary

Addresses

Primary practice location

1205 Troy Schenectady Rd Ste 101
Latham, NY 12110-1074

Mailing address

PO Box 304
Glens Falls, NY 12801
Phone (518) 926-6620

Other practice location 1

102 Park St
CR Wood Cancer Center
Glens Falls, NY 12801-4403
Phone (518) 926-6620

Other identifiers 1

IdentifierTypeStateIssuer
03390892MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
015172NYMDClinical Psychologist

Interoperability endpoints

  • Direct secure messaging: lcabana@landmarkhealth-direct.org

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1317254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571788800000",
    "number": "1003190802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 304",
            "city": "GLENS FALLS",
            "state": "NY",
            "postal_code": "12801",
            "telephone_number": "518-926-6620",
            "fax_number": "518-926-1954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 TROY SCHENECTADY RD STE 101",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121101074",
            "telephone_number": "518-348-3176"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "102 Park St",
            "address_2": "CR Wood Cancer Center",
            "address_purpose": "LOCATION",
            "city": "Glens Falls",
            "state": "NY",
            "postal_code": "128014403",
            "country_code": "US",
            "telephone_number": "518-926-6620",
            "fax_number": "518-926-1954",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CABANA",
        "first_name": "LAUREN",
        "middle_name": "M",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-29",
        "last_updated": "2019-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "015172",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03390892",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Latham, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.