Lauren E Bovelle, R.P.A.

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

P86106 Issued in NY

Practice address

16 Van Cott Rd Ste 2E
Deer Park, NY 11729-6519

Phone

(631) 274-0777

NPI assigned

Oct 16, 2012

Last updated

Oct 30, 2013By the provider in NPPES

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

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• South Shore Medical Care, PC

  • Family Medicine Physician
  • Deer Park, NY
  • NPI 1861696171
  Medicare reassignment

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

{
    "created_epoch": "1350345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383091200000",
    "number": "1679826697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 VAN COTT RD STE 2E",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "117296519",
            "telephone_number": "631-274-0777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 VAN COTT RD STE 2E",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "117296519",
            "telephone_number": "631-274-0777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOVELLE",
        "first_name": "LAUREN",
        "middle_name": "E",
        "credential": "R.P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-16",
        "last_updated": "2013-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "P86106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott Christopher Bonner
• Robert Anthony Borruso, ATC, CSCS
• Diana Bosinski
• Lourdes Marie Boursiquot, LPN
• Elaine Elizabeth Bova, LMSW
• Dennis Boyle, LCSW
• Jacqueline Bracht
• Anthony A Brazill, MSED
• Nadege Bredy
• Sarafina Brewer, COVT

• Medical Physician Assistant in Deer Park, NY
• Providers in Deer Park, NY by specialty
• Medical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2013; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.