Individual provider Active NPI

Lianna Marie Carroll, PA

  • Physician Assistant
  • West Seneca, NY
National Provider Identifier
1659873776
Registry record updated Jan 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
022202 Issued in NY
Practice address
1026 Union Road
West Seneca, NY 14224
Phone
(716) 712-0851
Fax
(716) 712-0853
NPI assigned
Mar 5, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X 022202 NY Primary

Addresses

Primary practice location

1026 Union Road
West Seneca, NY 14224

Mailing address

1026 Union Road
West Seneca, NY 14224
Phone (716) 712-0851

Other identifiers 1

IdentifierTypeStateIssuer
05215581MedicaidNY

Other names 1

  • Lianna Marie Ferger Former name

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
I20180725002751 NY Practitioner - Physician Assistant 0446507156 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southgate Medical Group LLPGroup PAC ID 7911810189, 31 clinicians

Practice addresses (Care Compare)

1026 Union Rd
West Seneca, NY 14224-3445
Phone (716) 712-0851

112 Olean St
East Aurora, NY 14052-2540
Phone (716) 712-0851

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
022202NYMDSpeech-Language Pathologist

Interoperability endpoints

  • Direct secure messaging: lcarroll@smg.medentdirect.com

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

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1520208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579132800000",
    "number": "1659873776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1026 UNION ROAD",
            "city": "WEST SENECA",
            "state": "NY",
            "postal_code": "14224",
            "telephone_number": "716-712-0851",
            "fax_number": "716-712-0853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1026 UNION ROAD",
            "city": "WEST SENECA",
            "state": "NY",
            "postal_code": "14224",
            "telephone_number": "716-712-0851",
            "fax_number": "716-712-0853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "LIANNA",
        "middle_name": "MARIE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-05",
        "last_updated": "2020-01-16",
        "certification_date": "2020-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "022202",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05215581",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LIANNA",
            "last_name": "FERGER",
            "middle_name": "MARIE",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in West Seneca, NY

Sources for this page

Verify at the official NPI Registry.