Dustin James Lenz-Emmi

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

774108 Issued in NY

Practice address

790 Green Meadow Dr
Macedon, NY 14502-8641

Phone

(585) 214-9018

NPI assigned

Dec 11, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1607644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607644800000",
    "number": "1003412255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 GREEN MEADOW DR",
            "city": "MACEDON",
            "state": "NY",
            "postal_code": "145028641",
            "telephone_number": "585-214-9018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 GREEN MEADOW DR",
            "city": "MACEDON",
            "state": "NY",
            "postal_code": "145028641",
            "telephone_number": "585-214-9018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LENZ-EMMI",
        "first_name": "DUSTIN",
        "middle_name": "JAMES",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-12-11",
        "last_updated": "2020-12-11",
        "certification_date": "2020-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "774108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Macedon",
            "affiliation": "N",
            "address_1": "790 Green Meadow Dr",
            "city": "Macedon",
            "state": "NY",
            "country_code": "US",
            "postal_code": "145028641",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• McLeana Elizabeth Kostraba, PT
• Hayley Anne Labigan
• Paris Marie Leibenguth, MS-CCC-SLP/L
• Lekhraj B. Kachoria MD PC
• Ellen Lennon, RN
• Diane Liburd-Severin, RN
• Richard J Little, LMSW
• Haines Lockhart III, LMHC
• Erin Lonergan, DPT
• Macedon Dentistry PLLC

• All providers in Macedon, NY
• Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2020; 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.