Maureen K Lundergan, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

1650381205 Issued in UT

Practice address

6333 Main St
Williamsville, NY 14221-5800

Phone

(716) 632-3545

Fax

(716) 632-6368

NPI assigned

Jun 16, 2005

Reactivated

Apr 4, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Department of Ophthalmology

  • Ophthalmology Physician
  • Salt Lake City, UT
  • NPI 1851327415
  NPD (past)

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376352000000",
    "number": "1306841226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6333 MAIN ST",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142215800",
            "telephone_number": "716-632-3545",
            "fax_number": "716-632-6368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6333 MAIN ST",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142215800",
            "telephone_number": "716-632-3545",
            "fax_number": "716-632-6368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNDERGAN",
        "first_name": "MAUREEN",
        "middle_name": "K",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-16",
        "last_updated": "2013-08-13",
        "deactivation_date": "2006-03-18",
        "reactivation_date": "2006-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "UT",
            "license": "1650381205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Luchan
• Ashley Ludwick, LPN
• Mark Earl Ludwig, RPH
• Allison Luksch, PA
• William Lumadue
• Jill Ann Lundy, LPN
• Meagan Lutgen, LPN
• Prerna Luthra, DO
• Jennifer Lutz, LPN
• Jenna Luzi, PA-C

• Ophthalmology Physician in Williamsville, NY
• Providers in Williamsville, NY by specialty
• Ophthalmology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2013; 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.