Individual provider Active NPI

Lauren Cordova, PA-C

  • Physician Assistant
  • Poughkeepsie, NY
National Provider Identifier
1760196471
Registry record updated Jan 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
45 Reade PL
Poughkeepsie, NY 12601-3947
Phone
(845) 454-8500
NPI assigned
Jan 9, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2023

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 Primary

Addresses

Primary practice location

45 Reade PL
Poughkeepsie, NY 12601-3947

Mailing address

51 Traci LN
Hopewell Junction, NY 12533-6009
Phone (845) 674-5324

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
I20230628002362 NY Practitioner - Physician Assistant 9739547423 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nuvance Health Medical Practice PCGroup PAC ID 1658468442, 578 clinicians

Practice addresses (Care Compare)

45 Reade PL
Poughkeepsie, NY 12601-3947

Hospital & facility affiliations

  • Vassar Brothers Medical Center Hospital, Poughkeepsie, NY, CCN 330023

Merit-based Incentive Payment System (MIPS)

Final score
81.38 of 100Reported as group
Quality
63.01
Promoting interoperability
98
Improvement activities
40
Cost
72.3

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Nuvance Health Medical Practice PC CurrentSince May 17, 2023 Accepting new patients

Locations

1 Columbia St
Ste 300
Poughkeepsie, NY 12601
Phone (845) 483-0100

45 Reade Pl
Fl 2
Poughkeepsie, NY 12601
Phone (845) 483-6001

45 Reade Pl
Poughkeepsie, NY 12601
Phone (845) 331-3131

Organizations & group practices 1

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.

Hospital & facility affiliations 2

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": "1673222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673222400000",
    "number": "1760196471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 TRACI LN",
            "city": "HOPEWELL JUNCTION",
            "state": "NY",
            "postal_code": "125336009",
            "telephone_number": "845-674-5324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 READE PL",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126013947",
            "telephone_number": "845-454-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORDOVA",
        "first_name": "LAUREN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-09",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poughkeepsie, NY

Sources for this page

Verify at the official NPI Registry.