Individual provider Active NPI

Lyndsay Mentgen, APN

  • Family Nurse Practitioner
  • Rockford, IL
National Provider Identifier
1417374059
Registry record updated Nov 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.010992 Issued in IL
Practice address
4215 Newburg Rd
Rockford, IL 61108-6479
Phone
(815) 988-8500
Fax
(815) 977-5956
NPI assigned
Mar 20, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209.010992 IL Primary

Addresses

Primary practice location

4215 Newburg Rd
Rockford, IL 61108-6479

Mailing address

4215 Newburg Rd
Rockford, IL 61108-6479
Phone (815) 988-8500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20161007000907 IL Practitioner - Nurse Practitioner 3577851534 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Carend Provider Group PAGroup PAC ID 2264827518, 26 clinicians

Practice addresses (Care Compare)

6018 N Wickwood Rd
Peoria, IL 61614-3529
Phone (708) 630-1534

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
58.33 of 100Reported as group
Quality
41.25
Promoting interoperability
0
Improvement activities
40
Cost
69.86

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209.010992ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carend Provider Group PA CurrentSince Dec 1, 2025 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

2045 W Grand Ave
Ste B
Chicago, IL 60612
Phone (800) 827-7437

2045 W Grand Ave
Chicago, IL 60612
Phone (312) 448-7310

101 Eisenhower Pkwy
Ste 300
Roseland, NJ 07068
Phone (201) 520-7221

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1395273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668384000000",
    "number": "1417374059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4215 NEWBURG RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611086479",
            "telephone_number": "815-988-8500",
            "fax_number": "815-977-5956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4215 NEWBURG RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611086479",
            "telephone_number": "815-988-8500",
            "fax_number": "815-977-5956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENTGEN",
        "first_name": "LYNDSAY",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-20",
        "last_updated": "2022-11-14",
        "certification_date": "2022-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.010992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.