Individual provider Active NPI

Lindsay Roderick, ATC

  • Physician Assistant
  • Hamden, CT
National Provider Identifier
1760001820
Registry record updated Dec 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
275 Mount Carmel Ave
Hamden, CT 06518-1961
Phone
(860) 748-8415
NPI assigned
Apr 9, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 3, 2020

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 NY Primary

Addresses

Primary practice location

275 Mount Carmel Ave
Hamden, CT 06518-1961

Mailing address

275 Mount Carmel Ave
Hamden, CT 06518-1961
Phone (860) 748-8415

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
I20210728000425 NY Practitioner - Physician Assistant 9133522154 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1427 Madison Ave
New York, NY 10029-6514
Phone (212) 731-3609

5 E 98TH St 2ND FL
OB/GYN Dept of Mount Sinai
New York, NY 10029-6501
Phone (212) 241-2232

5 E 98TH St-14TH FLR
OB/GYN Department
New York, NY 10029-6501
Phone (212) 241-2232

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
026070NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai CurrentSince Apr 21, 2021 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Apr 21, 2021 Accepting new patients

Locations

150 E 42nd St
Fl 10
New York, NY 10017
Phone (646) 605-8119

1427 Madison Ave
New York, NY 10029

5 E 98th St
Fl 2
New York, NY 10029
Phone (212) 241-6551

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1586390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606953600000",
    "number": "1760001820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 MOUNT CARMEL AVE",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065181961",
            "telephone_number": "860-748-8415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 MOUNT CARMEL AVE",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065181961",
            "telephone_number": "860-748-8415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODERICK",
        "first_name": "LINDSAY",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-09",
        "last_updated": "2020-12-03",
        "certification_date": "2020-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamden, CT

Sources for this page

Verify at the official NPI Registry.