Individual provider Active NPI

Ann Marie Lagonegro, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Rochester, NY
National Provider Identifier
1336291368
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
401005 Issued in NY
Practice address
490 Ridge Rd E
Rochester, NY 14621-1229
Phone
(585) 922-1122
Fax
(585) 922-2646
NPI assigned
Jan 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 401005 NY Primary

Addresses

Primary practice location

490 Ridge Rd E
Rochester, NY 14621-1229

Mailing address

490 Ridge Rd E
Rochester, NY 14621-1229
Phone (585) 922-1122

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
401005NYMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336291368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "490 RIDGE RD E",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146211229",
            "telephone_number": "585-922-1122",
            "fax_number": "585-922-2646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "490 RIDGE RD E",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146211229",
            "telephone_number": "585-922-1122",
            "fax_number": "585-922-2646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAGONEGRO",
        "first_name": "ANN MARIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "401005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.