Individual provider Active NPI

Lauren Puccia, PT

  • Physical Medicine & Rehabilitation Physician
  • Rochester, NY
National Provider Identifier
1356557862
Registry record updated Jul 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
023773 Issued in NY
Practice address
384 East Ave
Suite B
Rochester, NY 14607-1909
Phone
(585) 720-9608
NPI assigned
May 14, 2007
Last updated
Jul 8, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 023773 NY Primary

Addresses

Primary practice location

384 East Ave
Suite B
Rochester, NY 14607-1909

Mailing address

2050 South Clinton Avenue
Rochester, NY 14618-5727
Phone (585) 720-9608

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080318000038 NY Practitioner - Physical Therapist in Private Practice 6608951587 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Rehabilitation Physical Therapy Services LLC CurrentSince Oct 1, 2023 Accepting new patients
Freedom Therapy, Occupational Therapy, P.C. Physical Medicine & Rehabilitation PastSince Dec 1, 2007 Accepting new patients

Locations

7 Carnegie Plz
Cherry Hill, NJ 08003

1415 Richmond Ave
Staten Island, NY 10314
Phone (212) 475-5540

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436313600000",
    "number": "1356557862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 SOUTH CLINTON AVENUE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146185727",
            "telephone_number": "585-720-9608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "384 EAST AVE",
            "address_2": "SUITE B",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146071909",
            "telephone_number": "585-720-9608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUCCIA",
        "first_name": "LAUREN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-14",
        "last_updated": "2015-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "023773",
            "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, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.