Individual provider Active NPI

Lucille D'Agostino

  • Nurse Practitioner
  • Ogdensburg, NY
National Provider Identifier
1477170702
Registry record updated Mar 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
346045 Issued in NY
Practice address
5 Lyon PL
Ogdensburg, NY 13669-2586
Phone
(315) 393-2314
Fax
(315) 393-3873
NPI assigned
Jul 2, 2020
Last updated
Mar 22, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 346045 NY Primary
Family Nurse Practitioner 363LF0000X 346045 NY

Addresses

Primary practice location

5 Lyon PL
Ogdensburg, NY 13669-2586

Mailing address

214 King St
Ogdensburg, NY 13669-1142
Phone (315) 393-3600

Other identifiers 1

IdentifierTypeStateIssuer
06505311MedicaidNY

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
I20210218000288 NY Practitioner - Nurse Practitioner 2163593997 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carthage Area Hospital IncGroup PAC ID 9931010485, 119 clinicians

Practice addresses (Care Compare)

1001 W St
Carthage, NY 13619-9703
Phone (315) 493-1000

214 King St
Suite a
Ogdensburg, NY 13669-1142
Phone (315) 393-3600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
346045NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carthage Area Hospital Inc CurrentSince Apr 6, 2025 Accepting new patients
Carthage Area Hospital Inc Current Accepting new patients
Hospice of St Lawrence Valley Inc CurrentSince Jul 13, 2020 Accepting new patients
Carthage Area Hospital Inc CurrentSince Apr 6, 2025 Accepting new patients
Claxton-Hepburn Medical Center CurrentSince Mar 1, 2022 Accepting new patients

Locations

39 W Main St
Canton, NY 13617
Phone (315) 379-4700

1001 West St
Carthage, NY 13619
Phone (315) 493-1000

214 King St
Ogdensburg, NY 13669
Phone (315) 713-5660

5 Lyon Pl
Ogdensburg, NY 13669
Phone (315) 393-2314

Interoperability endpoints

  • Direct secure messaging: ldagostino@hiemail.healtheconnections.org

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

Hospital & facility affiliations 1

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": "1593648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647907200000",
    "number": "1477170702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 KING ST",
            "city": "OGDENSBURG",
            "state": "NY",
            "postal_code": "136691142",
            "telephone_number": "315-393-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 LYON PL",
            "city": "OGDENSBURG",
            "state": "NY",
            "postal_code": "136692586",
            "telephone_number": "315-393-2314",
            "fax_number": "315-393-3873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "D'AGOSTINO",
        "first_name": "LUCILLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-02",
        "last_updated": "2022-03-22",
        "certification_date": "2022-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "346045",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "346045",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06505311",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ogdensburg, NY

Sources for this page

Verify at the official NPI Registry.