Lauren C Derrick, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

301621 Issued in NY

Practice address

5112 W Taft Rd Ste J
Liverpool, NY 13088-4866

Phone

(315) 701-2170

Fax

(315) 701-2185

NPI assigned

Jul 11, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Nurse Practitioner

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Department of Medicine Medical Serv GRP at Suny HLTH Sci Ctr Syr inGroup PAC ID 3274445796, 277 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University Hospital S U N Y Health Science Center Hospital, Syracuse, NY, CCN 330241
• Oswego Hospital Hospital, Oswego, NY, CCN 330218
• Auburn Community Hospital Hospital, Auburn, NY, CCN 330235

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lderrick88572@direct.upstate.edu

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.

• Department of Medicine Medical Serv GRP at Suny HLTH Sci Ctr Syr in

  • Internal Medicine Physician
  • Syracuse, NY
  • NPI 1063468239
  Medicare reassignment Care Compare group NPD
• St Josephs Medical PC

  • Family Medicine Physician
  • Liverpool, NY
  • NPI 1942501747
  Medicare reassignment NPD
• Department of Medicine Medical Service Group

  • Hematology & Oncology Physician
  • Homer, NY
  • NPI 1205104262
  NPD
• North Medical PC

  • Family Medicine Physician
  • Liverpool, NY
  • NPI 1972563070
  NPD

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

• Auburn Community Hospital

  • General Acute Care Hospital
  • Auburn, NY
  • NPI 1093712911
  Care Compare affiliation
• Oswego Hospital

  • General Acute Care Hospital
  • Oswego, NY
  • NPI 1871678458
  Care Compare affiliation
• Suny Health Science Center at Syracuse

  • General Acute Care Hospital
  • Syracuse, NY
  • NPI 1578554630
  Care Compare affiliation

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

{
    "created_epoch": "1121040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569456000000",
    "number": "1669470951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 TOWNE DR",
            "city": "FAYETTEVILLE",
            "state": "NY",
            "postal_code": "130661331",
            "telephone_number": "315-663-0500",
            "fax_number": "315-663-0514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5112 W TAFT RD STE J",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130884866",
            "telephone_number": "315-701-2170",
            "fax_number": "315-701-2185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERRICK",
        "first_name": "LAUREN",
        "middle_name": "C",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-11",
        "last_updated": "2019-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "301621",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01980230",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Steven R Delisle, NP
• Stephanie Demaso, MD
• David Anthony Denigris
• Michelle L. Depalmo, NP
• Angelo R. Derosalia, MD
• Karilyn Despain
• Chelsea Devine, RN
• Regina Marie Devito, O.D.
• Hailey Dewitt
• Justin Michael Dexter, MD

• Adult Health Nurse Practitioner in Liverpool, NY
• Providers in Liverpool, NY by specialty
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.