Individual provider Active NPI

Frederick Wade Lincoln Jr., CRNA

  • Certified Registered Nurse Anesthetist
  • Lancaster, PA
National Provider Identifier
1316474240
Registry record updated Jun 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN612723 Issued in PA
Practice address
231 Granite Run Drive
Lancaster, PA 17601-6823
Phone
(717) 560-4200
Fax
(717) 560-4159
NPI assigned
May 23, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN612723 PA Primary

Addresses

Primary practice location

231 Granite Run Drive
Lancaster, PA 17601-6823

Mailing address

231 Granite Run Drive
Lancaster, PA 17601-6823
Phone (717) 560-4200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170627001665 PA Practitioner - Certified Registered Nurse Anesthetist (Crna) 5597034041 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lancaster Orthopedic Group, Inc.Group PAC ID 1557264678, 76 clinicians

Practice addresses (Care Compare)

231 Granite Run Dr
Lancaster, PA 17601-6823
Phone (717) 560-4200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN612723PAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
North American Partners in Anesthesia, Pennsylvania , LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2017 Accepting new patients
Prime Anesthesia Associates PC CurrentSince May 1, 2018 Accepting new patients
Lancaster Orthopedic Group, Inc. CurrentSince Jul 1, 2024 Accepting new patients

Locations

68 S Service Rd
Ste 350
Melville, NY 11747
Phone (516) 945-3107

206 E Brown St
East Stroudsburg, PA 18301
Phone (570) 420-4951

810 Plaza Blvd
Ste 101
Lancaster, PA 17601
Phone (717) 431-2368

231 Granite Run Dr
Lancaster, PA 17601
Phone (717) 560-4200

8835 Germantown Ave
Philadelphia, PA 19118
Phone (215) 248-8227

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.

NPI Registry JSON

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

{
    "created_epoch": "1495497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717632000000",
    "number": "1316474240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "231 GRANITE RUN DRIVE",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176016823",
            "telephone_number": "717-560-4200",
            "fax_number": "717-560-4159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "231 GRANITE RUN DRIVE",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176016823",
            "telephone_number": "717-560-4200",
            "fax_number": "717-560-4159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINCOLN",
        "first_name": "FREDERICK",
        "middle_name": "WADE",
        "name_suffix": "Jr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-23",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "RN612723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.