Individual provider Active NPI

Sara Lauterbach, PA-C

  • Physician Assistant
  • Cobleskill, NY
National Provider Identifier
1659960920
Registry record updated Jul 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
027443 Issued in NY
Practice address
136 Parkway Dr
Cobleskill, NY 12043-5150
Phone
(518) 234-3450
Fax
(518) 234-3415
NPI assigned
Jan 12, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2022

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 027443 NY Primary

Addresses

Primary practice location

136 Parkway Dr
Cobleskill, NY 12043-5150

Mailing address

1 Atwell Rd
Cooperstown, NY 13326-1301
Phone (518) 234-3450

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
I20211216000891 NY Practitioner - Physician Assistant 4880085364 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mary Imogene Bassett HospitalGroup PAC ID 3779488325, 780 clinicians

Practice addresses (Care Compare)

136 Pkwy Dr
Cobleskill, NY 12043-5150
Phone (518) 234-2555

178 Grandview Dr
Cobleskill, NY 12043-5144
Phone (518) 254-3456

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.62 of 100Reported as apm
Quality
77.97
Promoting interoperability
98
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
027443NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Imogene Bassett Hospital CurrentSince Dec 6, 2021 Accepting new patients
Mary Imogene Bassett Hospital CurrentSince Dec 6, 2021 Accepting new patients

Locations

136 Parkway Dr
Cobleskill, NY 12043
Phone (518) 234-2555

178 Grandview Dr
Cobleskill, NY 12043
Phone (518) 254-3456

1 Atwell Rd
Cooperstown, NY 13326
Phone (607) 547-3480

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 1

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": "1610409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658275200000",
    "number": "1659960920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ATWELL RD",
            "city": "COOPERSTOWN",
            "state": "NY",
            "postal_code": "133261301",
            "telephone_number": "518-234-3450",
            "fax_number": "518-234-3415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 PARKWAY DR",
            "city": "COBLESKILL",
            "state": "NY",
            "postal_code": "120435150",
            "telephone_number": "518-234-3450",
            "fax_number": "518-234-3415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAUTERBACH",
        "first_name": "SARA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-12",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "027443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cobleskill, NY

Sources for this page

Verify at the official NPI Registry.