Individual provider Active NPI

Vincent Lorenz II, PA

  • Physician Assistant
  • Williamsville, NY
National Provider Identifier
1700899887
Registry record updated May 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
006507 Issued in NY
Practice address
192 Park Club LN
Suite 100
Williamsville, NY 14221-5270
Phone
(716) 204-1101
Fax
(716) 204-0914
NPI assigned
Aug 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2015

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 006507 NY Primary

Addresses

Primary practice location

192 Park Club LN
Suite 100
Williamsville, NY 14221-5270

Mailing address

192 Park Club LN
Suite 100
Williamsville, NY 14221-5270
Phone (716) 204-1101

Other identifiers 1

IdentifierTypeStateIssuer
BA0215OtherNYMEDICARE GROUP #

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
I20061025000597 NY Practitioner - Physician Assistant 3577560069 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trinity Medical Wny PCGroup PAC ID 5193907517, 207 clinicians

Practice addresses (Care Compare)

192 Park Club LN
Williamsville, NY 14221-5270

3435 Bailey Ave
Buffalo, NY 14215-1194
Phone (716) 835-2966

4901 Camp Rd
Suite 100
Hamburg, NY 14075-2625
Phone (716) 204-1101

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Medical Wny PC CurrentSince Oct 1, 2019 Accepting new patients
Valerie Vullo M.D., LLC Past Accepting new patients

Locations

144 Genesee St
Fl 3
Buffalo, NY 14203
Phone (716) 601-3690

3435 Bailey Ave
Buffalo, NY 14215
Phone (716) 835-2966

4901 Camp Rd
Ste 100
Hamburg, NY 14075

192 Park Club Ln
Ste 100
Williamsville, NY 14221
Phone (716) 667-7463

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431907200000",
    "number": "1700899887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "192 PARK CLUB LN",
            "address_2": "SUITE 100",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142215270",
            "telephone_number": "716-204-1101",
            "fax_number": "716-204-0914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "192 PARK CLUB LN",
            "address_2": "SUITE 100",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142215270",
            "telephone_number": "716-204-1101",
            "fax_number": "716-204-0914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LORENZ",
        "first_name": "VINCENT",
        "name_suffix": "II",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-13",
        "last_updated": "2015-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "006507",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP #",
            "identifier": "BA0215",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

Verify at the official NPI Registry.