Individual provider Active NPI

Denise M Lougee, PA

  • Medical Physician Assistant
  • East Syracuse, NY
National Provider Identifier
1548419351
Registry record updated Feb 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PENDING Issued in NY
Practice address
5008 Brittonfield Pkwy Ste 700
East Syracuse, NY 13057-9249
Phone
(315) 472-7504
Fax
(315) 634-4677
NPI assigned
Sep 17, 2008
Last updated
Feb 12, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2020

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 PENDING NY Primary

Addresses

Primary practice location

5008 Brittonfield Pkwy Ste 700
East Syracuse, NY 13057-9249

Mailing address

5008 Brittonfield Pkwy Ste 700
East Syracuse, NY 13057-9249
Phone (315) 472-7504

Other practice location 1

4103 Medical Center Dr
Fayetteville, NY 13066-6600
Phone (315) 637-7800

Other identifiers 1

IdentifierTypeStateIssuer
03152614MedicaidNY

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
I20081212000412 NY Practitioner - Physician Assistant 9638230378 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hematology-Oncology Associates of Cny, PCGroup PAC ID 6709787823, 65 clinicians

Practice addresses (Care Compare)

5008 Brittonfield Pkwy
East Syracuse, NY 13057-9248
Phone (315) 472-7504

5490 Cobbler Way
Camillus, NY 13031-4309
Phone (315) 472-7504

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PENDINGNYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cny North Urgent Care PLLC Past Accepting new patients

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

NPI Registry JSON

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

{
    "created_epoch": "1221609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581465600000",
    "number": "1548419351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5008 BRITTONFIELD PKWY STE 700",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130579249",
            "telephone_number": "315-472-7504",
            "fax_number": "315-634-4677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5008 BRITTONFIELD PKWY STE 700",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130579249",
            "telephone_number": "315-472-7504",
            "fax_number": "315-634-4677"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4103 Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NY",
            "postal_code": "130666600",
            "country_code": "US",
            "telephone_number": "315-637-7800",
            "fax_number": "315-637-7808",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOUGEE",
        "first_name": "DENISE",
        "middle_name": "M",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-17",
        "last_updated": "2020-02-12",
        "certification_date": "2020-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "PENDING",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03152614",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Syracuse, NY

Sources for this page

Verify at the official NPI Registry.