Individual provider Active NPI

Timothy J Lensing, PA

  • Medical Physician Assistant
  • Rutland, VT
National Provider Identifier
1306802194
Registry record updated Jul 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
055-0030458 Issued in VT
Practice address
215 Stratton Rd
Rutland, VT 05701-4621
Phone
(802) 772-3386
Fax
(802) 773-4578
NPI assigned
Apr 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 055-0030458 VT Primary

Addresses

Primary practice location

215 Stratton Rd
Rutland, VT 05701-4621

Mailing address

215 Stratton Rd
Rutland, VT 05701-4621
Phone (802) 855-2027

Other identifiers 1

IdentifierTypeStateIssuer
9000248MedicaidVT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
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
I20061221000374 VT Practitioner - Physician Assistant 5193725109 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
055-0030458VTMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Centers of the Rutland Region Inc CurrentSince Jul 1, 2011 Accepting new patients

Locations

275 VT 30 N
Bomoseen, VT 05732
Phone (802) 468-5641

71 Allen St
Ste 402
Rutland, VT 05701
Phone (800) 468-9118

215 Stratton Rd
Rutland, VT 05701
Phone (802) 773-3386

2987 Vt Route 22A
Shoreham, VT 05770
Phone (802) 897-7000

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1145577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437436800000",
    "number": "1306802194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 STRATTON RD",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "057014621",
            "telephone_number": "802-855-2027",
            "fax_number": "802-855-2053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 STRATTON RD",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "057014621",
            "telephone_number": "802-772-3386",
            "fax_number": "802-773-4578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LENSING",
        "first_name": "TIMOTHY",
        "middle_name": "J",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-21",
        "last_updated": "2015-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VT",
            "license": "055-0030458",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000248",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rutland, VT

Sources for this page

Verify at the official NPI Registry.