Individual provider Active NPI

Lindsay Marie Roberge, DDS

  • Dentist
  • Rochester, NY
National Provider Identifier
1366199093
Registry record updated Jul 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
063137 Issued in NY
Practice address
1455 E Ridge Rd
Rochester, NY 14621-2006
Phone
(585) 974-5045
NPI assigned
Mar 2, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 063137 NY Primary

Addresses

Primary practice location

1455 E Ridge Rd
Rochester, NY 14621-2006

Mailing address

523 E Main St
Palmyra, NY 14522-1144
Phone (315) 387-4335

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231211000521 NY Practitioner - Dentist 6901255454 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
063137NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Clifton Springs Sanitarium Co CurrentSince Oct 31, 2023 Accepting new patients
Rochester General Hospital CurrentSince Oct 31, 2023 Accepting new patients
Rochester General Hospital CurrentSince Oct 31, 2023 Accepting new patients

Locations

2 Coulter Rd
Clifton Springs, NY 14432
Phone (315) 462-1472

1425 Portland Ave
Rochester, NY 14621
Phone (585) 922-3122

100 Kings Hwy S
Rochester, NY 14617
Phone (585) 922-0553

1455 E Ridge Rd
Rochester, NY 14621
Phone (585) 922-4103

Interoperability endpoints

  • Direct secure messaging: lroberge347933@direct.rochesterregional.org

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": "1646179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688688000000",
    "number": "1366199093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "523 E MAIN ST",
            "city": "PALMYRA",
            "state": "NY",
            "postal_code": "145221144",
            "telephone_number": "315-387-4335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1455 E RIDGE RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146212006",
            "telephone_number": "585-974-5045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERGE",
        "first_name": "LINDSAY",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-02",
        "last_updated": "2023-07-07",
        "certification_date": "2023-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "063137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.