Individual provider Active NPI

Lauren Alison Hertwig, NP

  • Family Nurse Practitioner
  • Riverhead, NY
National Provider Identifier
1609204239
Registry record updated Apr 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
351210 Issued in NY
Practice address
21 E 2ND St
Riverhead, NY 11901-4686
Phone
(631) 873-9257
Fax
(631) 206-9299
NPI assigned
Oct 16, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X F401648-1 NY
Family Nurse Practitioner 363LF0000X 351210 NY Primary

Addresses

Primary practice location

21 E 2ND St
Riverhead, NY 11901-4686

Mailing address

9 Amys Path
East Quogue, NY 11942-4131
Phone (631) 872-3788

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
I20140808000315 NY Practitioner - Nurse Practitioner 6901023316 Reassigns benefits to 1 organization
Practice locations: Quogue, NY; Riverhead, NY

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

35 Montauk Hwy
Suite 1
Quogue, NY 11959-4000
Phone (631) 873-9257

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
351210NYMDFamily Nurse Practitioner
F401648-1NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
RS Neuro Medical, P.C. CurrentSince Aug 13, 2016 Accepting new patients
Peconic Wellness NP - Psychiatry Services PLLC Psychiatric/Mental Health CurrentSince Jun 25, 2022 Accepting new patients

Locations

15 W Montauk Hwy
Hampton Bays, NY 11946
Phone (631) 723-2273

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1381881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682380800000",
    "number": "1609204239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 AMYS PATH",
            "city": "EAST QUOGUE",
            "state": "NY",
            "postal_code": "119424131",
            "telephone_number": "631-872-3788",
            "fax_number": "631-206-9299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 E 2ND ST",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119014686",
            "telephone_number": "631-873-9257",
            "fax_number": "631-206-9299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERTWIG",
        "first_name": "LAUREN",
        "middle_name": "ALISON",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-16",
        "last_updated": "2023-04-25",
        "certification_date": "2023-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F401648-1",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "351210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverhead, NY

Sources for this page

Verify at the official NPI Registry.