Individual provider Active NPI

Paul W Lenkowski Jr., M.D.PH.D.

  • Otolaryngology Physician
  • Roanoke, VA
National Provider Identifier
1497964886
Registry record updated Apr 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
0101247485 Issued in VA
Practice address
4633 Brambleton Ave Ste 100
Roanoke, VA 24018-3410
Phone
(540) 968-7368
Fax
(844) 212-0402
NPI assigned
May 22, 2007
Last updated
Apr 27, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 0101247485 VA Primary

Addresses

Primary practice location

4633 Brambleton Ave Ste 100
Roanoke, VA 24018-3410

Mailing address

PO Box 8310
Roanoke, VA 24014-0310
Phone (540) 345-3556

Other practice location 1

1902 Braeburn Dr Ste 130
Salem, VA 24153-7304
Phone (540) 444-8100

Other practice location 2

2154 McVitty Rd SW Fl 2
Roanoke, VA 24018-1642
Phone (540) 968-7368

Other identifiers 1

IdentifierTypeStateIssuer
1497964886MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100902001006 VA Practitioner - Otolaryngology 9739203399 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Virginia School of Medicine, 2010
Medicare assignment
May accept Medicare assignment
Group practices
Roanoke Valley ENT and Allergy PCGroup PAC ID 6305199324, 5 clinicians

Practice addresses (Care Compare)

4633 Brambleton Ave
Suite 100
Roanoke, VA 24018-3410
Phone (540) 968-7368

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101247485VAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Roanoke Valley ENT & Allergy PC Otolaryngology CurrentSince Sep 1, 2018 Accepting new patients
Synergy Surgicalists LLC PastSince Sep 1, 2018 Accepting new patients

Locations

4633 Brambleton Ave
Ste 100
Roanoke, VA 24018
Phone (540) 968-7368

2154 McVitty Rd SW
Fl 2
Roanoke, VA 24018
Phone (540) 968-7368

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, 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": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682553600000",
    "number": "1497964886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8310",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240140310",
            "telephone_number": "540-345-3556",
            "fax_number": "540-342-2193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4633 BRAMBLETON AVE STE 100",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240183410",
            "telephone_number": "540-968-7368",
            "fax_number": "844-212-0402"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1902 Braeburn Dr Ste 130",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "VA",
            "postal_code": "241537304",
            "country_code": "US",
            "telephone_number": "540-444-8100",
            "fax_number": "540-772-2583",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2154 McVitty Rd SW Fl 2",
            "address_purpose": "LOCATION",
            "city": "Roanoke",
            "state": "VA",
            "postal_code": "240181642",
            "country_code": "US",
            "telephone_number": "540-968-7368",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LENKOWSKI",
        "first_name": "PAUL",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-22",
        "last_updated": "2023-04-27",
        "certification_date": "2023-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "VA",
            "license": "0101247485",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1497964886",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.