Individual provider Active NPI

Laurel A Dallmeyer, MD

  • Family Medicine Physician
  • Geneva, NY
National Provider Identifier
1619919206
Registry record updated Jan 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
176102 Issued in NY
Practice address
765 Geneva Crossing Way
Geneva, NY 14456
Phone
(315) 226-8997
Fax
(315) 789-1213
NPI assigned
Jun 11, 2006
Last updated
Jan 25, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 176102 NY Primary

Addresses

Primary practice location

765 Geneva Crossing Way
Geneva, NY 14456

Mailing address

765 Geneva Crossing Way
Geneva, NY 14456
Phone (315) 226-8997

Other identifiers 1

IdentifierTypeStateIssuer
01126347MedicaidNY

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081217000623 NY Practitioner - Family Practice 5294708954 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
176102NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Western New York Medical Practice P.C. Family Medicine CurrentSince Jun 1, 2015 Accepting new patients
The Frederick Ferris Thompson Hospital CurrentSince Feb 8, 2021 Accepting new patients
The Frederick Ferris Thompson Hospital CurrentSince Feb 8, 2021 Accepting new patients

Locations

495 N Main St
Canandaigua, NY 14424
Phone (585) 393-3515

73 Buffalo St
Ste 100
Canandaigua, NY 14424

1160 Corporate Dr
Ste 800
Farmington, NY 14425
Phone (585) 234-4855

1425 Portland Ave
Rochester, NY 14621
Phone (585) 922-3122

15 Canandaigua St
Shortsville, NY 14548
Phone (585) 289-3560

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": "1149984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674604800000",
    "number": "1619919206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "765 GENEVA CROSSING WAY",
            "city": "GENEVA",
            "state": "NY",
            "postal_code": "14456",
            "telephone_number": "315-226-8997",
            "fax_number": "315-789-1213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "765 GENEVA CROSSING WAY",
            "city": "GENEVA",
            "state": "NY",
            "postal_code": "14456",
            "telephone_number": "315-226-8997",
            "fax_number": "315-789-1213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALLMEYER",
        "first_name": "LAUREL",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-11",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "176102",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01126347",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Geneva, NY

Sources for this page

Verify at the official NPI Registry.