Individual provider Active NPI

Landyn Rae Sprague

  • Nurse Practitioner
  • Penfield, NY
National Provider Identifier
1073260402
Registry record updated Jul 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
349058 Issued in NY
Practice address
1835 Fairport Nine Mile Point Rd
Penfield, NY 14526-1903
Phone
(585) 758-0777
NPI assigned
Mar 6, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 349058 NY Primary

Addresses

Primary practice location

1835 Fairport Nine Mile Point Rd
Penfield, NY 14526-1903

Mailing address

1835 Fairport Nine Mile Point Rd
Penfield, NY 14526-1903
Phone (585) 758-0777

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address lsprague103114@direct.urmc.rochester.edu Direct
Direct Messaging Address lsprague103114@direct.urmc.rochester.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220607003234 NY Practitioner - Nurse Practitioner 5092193805 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of RochesterGroup PAC ID 5799699088, 960 clinicians

Practice addresses (Care Compare)

1835 Fairport Nine Mile Point Rd
Penfield, NY 14526-1903
Phone (585) 758-0777

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
University of Rochester CurrentSince Jul 1, 2022 Accepting new patients
University of Rochester CurrentSince Jul 1, 2022 Accepting new patients
University of Rochester Past Accepting new patients

Locations

1835 Fairport Nine Mile Point Rd
Penfield, NY 14526
Phone (585) 341-4000

1835 Fairport Nine Mile Point Rd
Ste 100
Penfield, NY 14526
Phone (585) 758-0777

2400 S Clinton Ave
#H
Rochester, NY 14618
Phone (585) 341-7299

601 Elmwood Ave
Rochester, NY 14642
Phone (585) 275-9555

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1646524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1073260402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1835 FAIRPORT NINE MILE POINT RD",
            "city": "PENFIELD",
            "state": "NY",
            "postal_code": "145261903",
            "telephone_number": "585-758-0777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1835 FAIRPORT NINE MILE POINT RD",
            "city": "PENFIELD",
            "state": "NY",
            "postal_code": "145261903",
            "telephone_number": "585-758-0777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPRAGUE",
        "first_name": "LANDYN",
        "middle_name": "RAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-06",
        "last_updated": "2023-07-17",
        "certification_date": "2022-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "349058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lsprague103114@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lsprague103114@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Penfield, NY

Sources for this page

Verify at the official NPI Registry.