NPIMap

Individual provider Active NPI

Wayne Allen Leblanc, PA-C

  • Physician Assistant
  • Lockport, NY
National Provider Identifier
1023585254
Registry record updated Oct 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
025063 Issued in NY
Practice address
6334 Robinson Rd
Lockport, NY 14094-7977
Phone
(716) 622-9568
NPI assigned
Oct 25, 2018
Last updated
Oct 1, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2020

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 025063 NY Primary

Addresses

Primary practice location

6334 Robinson Rd
Lockport, NY 14094-7977

Mailing address

4716 Beach Ridge Road
Lockport, NY 14094
Phone (716) 622-9568

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200819002574 NY Practitioner - Physician Assistant 8820414972 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Amandeep Pal MD PLLCGroup PAC ID 1254655293, 4 clinicians

Practice addresses (Care Compare)

521 E Ave
Eastern Niagara Hospital
Lockport, NY 14094-9497
Phone (716) 514-5700

5465 Upper Mountain Rd
Lockport, NY 14094-1854
Phone (716) 433-0790

6030 Edward Ave
Newfane, NY 14108-1009
Phone (716) 795-0077

Hospital & facility affiliations

National Provider Directory

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

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1540425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601510400000",
    "number": "1023585254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4716 BEACH RIDGE ROAD",
            "city": "LOCKPORT",
            "state": "NY",
            "postal_code": "14094",
            "telephone_number": "716-622-9568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6334 ROBINSON RD",
            "city": "LOCKPORT",
            "state": "NY",
            "postal_code": "140947977",
            "telephone_number": "716-622-9568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEBLANC",
        "first_name": "WAYNE",
        "middle_name": "ALLEN",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-10-25",
        "last_updated": "2020-10-01",
        "certification_date": "2020-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "025063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lockport, NY

Sources for this page

Verify at the official NPI Registry.