Individual provider Active NPI

Lauren P Wegge

  • Medical Physician Assistant
  • Lynbrook, NY
National Provider Identifier
1346525011
Registry record updated Sep 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
015227 Issued in NY
Practice address
777 Sunrise Hwy
Suite 200
Lynbrook, NY 11563-2950
Phone
(516) 887-3516
Fax
(516) 887-0331
NPI assigned
Oct 13, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2020

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 015227 NY Primary

Addresses

Primary practice location

777 Sunrise Hwy
Suite 200
Lynbrook, NY 11563-2950

Mailing address

777 Sunrise Hwy
Suite 200
Lynbrook, NY 11563-2950
Phone (516) 887-3516

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
I20111227000484 NY Practitioner - Physician Assistant 4486820313 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Gustave Levy Place
Mount Sinai Emergency Room
New York, NY 10029-6500
Phone (212) 241-4572

1111 Amsterdam Ave
New York, NY 10025-1716
Phone (212) 523-2400

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fpa Hospital Based CurrentSince Mar 1, 2020 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Aug 1, 2023 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Aug 1, 2023 Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients

Locations

2510 30th Ave
Long Island City, NY 11102
Phone (718) 267-4245

1000 10th Ave
New York, NY 10019
Phone (212) 523-2369

1111 Amsterdam Ave
New York, NY 10025
Phone (212) 523-2309

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359

Organizations & group practices 5

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": "1318464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599696000000",
    "number": "1346525011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 SUNRISE HWY",
            "address_2": "SUITE 200",
            "city": "LYNBROOK",
            "state": "NY",
            "postal_code": "115632950",
            "telephone_number": "516-887-3516",
            "fax_number": "516-887-0331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 SUNRISE HWY",
            "address_2": "SUITE 200",
            "city": "LYNBROOK",
            "state": "NY",
            "postal_code": "115632950",
            "telephone_number": "516-887-3516",
            "fax_number": "516-887-0331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEGGE",
        "first_name": "LAUREN",
        "middle_name": "P",
        "name_prefix": "Miss",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-13",
        "last_updated": "2020-09-10",
        "certification_date": "2020-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "015227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynbrook, NY

Sources for this page

Verify at the official NPI Registry.