Individual provider Active NPI

Lucinda Orlen Jungjohann, GNP

  • Gerontology Nurse Practitioner
  • Rochester, NY
National Provider Identifier
1598877912
Registry record updated Mar 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
F340534-1 Issued in NY
Practice address
105 Canal Landing Blvd
Suite 1
Rochester, NY 14626-5107
Phone
(585) 368-4050
Fax
(585) 723-6705
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X F340534-1 NY Primary

Addresses

Primary practice location

105 Canal Landing Blvd
Suite 1
Rochester, NY 14626-5107

Mailing address

105 Canal Landing Blvd
Suite 1
Rochester, NY 14626-5107
Phone (585) 368-4050

Other identifiers 1

IdentifierTypeStateIssuer
02749975MedicaidNY

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
I20040615001147 NY Practitioner - Nurse Practitioner 1254315591 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rochester Friendly HomeGroup PAC ID 0042122046, 6 clinicians

Practice addresses (Care Compare)

3156 E Ave
Rochester, NY 14618-3428
Phone (585) 381-1600

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F340534NYMDFamily Nurse Practitioner
F340534-1NYMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Unity Hospital of Rochester CurrentSince Sep 8, 2014 Accepting new patients
Rochester Friendly Home CurrentSince Mar 8, 2022 Accepting new patients
The Unity Hospital of Rochester CurrentSince Sep 8, 2014 Accepting new patients

Locations

1555 Long Pond Rd
Rochester, NY 14626
Phone (585) 429-2289

105 Canal Landing Blvd
Ste 1
Rochester, NY 14626
Phone (585) 368-4050

505 Mount Hope Ave
Rochester, NY 14620
Phone (585) 353-7678

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425254400000",
    "number": "1598877912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 CANAL LANDING BLVD",
            "address_2": "SUITE 1",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146265107",
            "telephone_number": "585-368-4050",
            "fax_number": "585-723-6705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 CANAL LANDING BLVD",
            "address_2": "SUITE 1",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146265107",
            "telephone_number": "585-368-4050",
            "fax_number": "585-723-6705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUNGJOHANN",
        "first_name": "LUCINDA",
        "middle_name": "ORLEN",
        "credential": "GNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2015-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NY",
            "license": "F340534-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02749975",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.