Individual provider Active NPI

Lynn M Wengender, PA

  • Medical Physician Assistant
  • Rochester, NY
National Provider Identifier
1366402851
Registry record updated May 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
004325 Issued in NY
Practice address
30 Hagen Dr
Suite #310
Rochester, NY 14625-2658
Phone
(585) 641-0400
Fax
(585) 641-0300
NPI assigned
Mar 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2021

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 004325 NY Primary

Addresses

Primary practice location

30 Hagen Dr
Suite #310
Rochester, NY 14625-2658

Mailing address

30 Hagen Dr
Suite #310
Rochester, NY 14625-2658
Phone (585) 641-0400

Other identifiers 2

IdentifierTypeStateIssuer
P019004325OtherNYBLUE CHOICE PROVIDER NO.
108994BJOtherNYPREFERRED CARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lwengender195349@direct.rochesterregional.org

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
I20071031000427 NY Practitioner - Physician Assistant 0941304877 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
96.62 of 100Reported as apm
Quality
74.51
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Unity Hospital of Rochester CurrentSince Mar 25, 2013 Accepting new patients
The Unity Hospital of Rochester CurrentSince Mar 25, 2013 Accepting new patients

Locations

105 Canal Landing Blvd
Ste 1
Rochester, NY 14626
Phone (585) 368-4050

1555 Long Pond Rd
Rochester, NY 14626
Phone (585) 429-2289

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": "1143417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620259200000",
    "number": "1366402851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 HAGEN DR",
            "address_2": "SUITE #310",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146252658",
            "telephone_number": "585-641-0400",
            "fax_number": "585-641-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 HAGEN DR",
            "address_2": "SUITE #310",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146252658",
            "telephone_number": "585-641-0400",
            "fax_number": "585-641-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENGENDER",
        "first_name": "LYNN",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-27",
        "last_updated": "2021-05-06",
        "certification_date": "2021-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "004325",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE PROVIDER NO.",
            "identifier": "P019004325",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CARE",
            "identifier": "108994BJ",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lwengender195349@direct.rochesterregional.org",
            "affiliation": "N",
            "address_1": "30 Hagen Dr",
            "address_2": "Suite #310",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146252658",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.