Individual provider Active NPI

Laurel Anne Delorme, P.A.

  • Physician Assistant
  • Cicero, NY
National Provider Identifier
1619980976
Registry record updated Aug 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
009587 Issued in NY
Practice address
8003 Brewerton Rd
Cicero, NY 13039-9528
Phone
(315) 288-4006
Fax
(315) 288-4760
NPI assigned
Aug 15, 2006
Sex
Female
Sole proprietor
No

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.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
009587NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Joseph J Pierz MD PC Past Accepting new patients
Atlantic Physician Services of Maryland, PC Physician Assistant Past Accepting new patients

NPPES NPI Registry

Updated by the provider on Aug 27, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 009587 NY Primary

Addresses

Primary practice location

8003 Brewerton Rd
Cicero, NY 13039-9528

Mailing address

PO Box 248
Ellicottville, NY 14731-0248
Phone (716) 699-9032

Other identifiers 1

IdentifierTypeStateIssuer
03448762MedicaidNY

NPI Registry JSON

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377561600000",
    "number": "1619980976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 248",
            "city": "ELLICOTTVILLE",
            "state": "NY",
            "postal_code": "147310248",
            "telephone_number": "716-699-9032",
            "fax_number": "716-699-9035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8003 BREWERTON RD",
            "city": "CICERO",
            "state": "NY",
            "postal_code": "130399528",
            "telephone_number": "315-288-4006",
            "fax_number": "315-288-4760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELORME",
        "first_name": "LAUREL",
        "middle_name": "ANNE",
        "name_prefix": "Miss",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-15",
        "last_updated": "2013-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "009587",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03448762",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cicero, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.