Individual provider Active NPI

Lily Mi Rondeau, PA-C

  • Physician Assistant
  • Cambridge, MA
National Provider Identifier
1487377958
Registry record updated Sep 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
551 Green St Apt 5
Cambridge, MA 02139-3221
Phone
(617) 833-9161
NPI assigned
Sep 20, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA Primary

Addresses

Primary practice location

551 Green St Apt 5
Cambridge, MA 02139-3221

Mailing address

551 Green St Apt 5
Cambridge, MA 02139-3221
Phone (617) 833-9161

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
I20240227004122 NY Practitioner - Physician Assistant 8921443128 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Boston University School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Columbia Memorial HospitalGroup PAC ID 5092709410, 171 clinicians

Practice addresses (Care Compare)

2827 US Route 9
Valatie, NY 12184-0785
Phone (518) 828-8051

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia Memorial Hospital CurrentSince Jan 16, 2024 Accepting new patients
Columbia Memorial Hospital CurrentSince Jan 16, 2024 Accepting new patients
Columbia Memorial Hospital Past Accepting new patients

Locations

159 Jefferson Hts
Ste D107
Catskill, NY 12414
Phone (518) 828-7280

71 Prospect Ave
Ste 190
Hudson, NY 12534
Phone (518) 697-3000

71 Prospect Ave
Hudson, NY 12534
Phone (518) 262-3773

2827 US Highway 9
Valatie, NY 12184
Phone (518) 828-7601

Interoperability endpoints

  • Direct secure messaging: lrondeau93067@albanymed.direct-ci.com

Organizations & group practices 4

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.

Hospital & facility affiliations 6

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": "1663632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663632000000",
    "number": "1487377958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "551 GREEN ST APT 5",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021393221",
            "telephone_number": "617-833-9161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "551 GREEN ST APT 5",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021393221",
            "telephone_number": "617-833-9161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RONDEAU",
        "first_name": "LILY",
        "middle_name": "MI",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-20",
        "last_updated": "2022-09-20",
        "certification_date": "2022-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MA

Sources for this page

Verify at the official NPI Registry.