Individual provider Active NPI

Lauren E Lavine, NP

  • Family Nurse Practitioner
  • North Syracuse, NY
National Provider Identifier
1780068221
Registry record updated Jul 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
339783 Issued in NY
Practice address
6846 Buckley Road
Nephrology Hypertension Associates of Cny, PC
North Syracuse, NY 13212
Phone
(315) 410-6400
Fax
(315) 410-6410
NPI assigned
Jul 15, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 339783 NY Primary

Addresses

Primary practice location

6846 Buckley Road
Nephrology Hypertension Associates of Cny, PC
North Syracuse, NY 13212

Mailing address

6846 Buckley Road
Nephrology Hypertension Associates of Cny, PC
North Syracuse, NY 13212
Phone (315) 410-6400

Other names 1

  • Lauren E Gildemeyer Former name

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
I20150827000987 NY Practitioner - Nurse Practitioner 4981910585 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Suny Health Science Center at SyracuseGroup PAC ID 7214833086, 210 clinicians

Practice addresses (Care Compare)

750 E Adams St
Syracuse, NY 13210-2306
Phone (315) 464-8093

Hospital & facility affiliations

  • University Hospital S U N Y Health Science Center Hospital, Syracuse, NY, CCN 330241

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Josephs Medical PC CurrentSince Jul 28, 2018 Accepting new patients
St. Joseph'S Physician Health, P.C. CurrentSince Jan 7, 2017 Accepting new patients
Suny Health Science Center at Syracuse Family CurrentSince Sep 5, 2019 Accepting new patients
Suny Health Science Center at Syracuse CurrentSince Sep 5, 2019 Accepting new patients
Suny Health Science Center at Syracuse Past Accepting new patients

Locations

5100 W Taft Rd
Ste 2T
Liverpool, NY 13088
Phone (315) 744-1592

61 Delano St
Pulaski, NY 13142
Phone (315) 298-4274

301 Prospect Ave
Syracuse, NY 13203
Phone (315) 448-5111

104 Union Ave
Syracuse, NY 13203
Phone (315) 422-4442

750 E Adams St
Syracuse, NY 13210
Phone (315) 464-4363

Interoperability endpoints

  • Direct secure messaging: llavine92493@direct.upstate.edu

Organizations & group practices 5

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 1

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": "1436918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436918400000",
    "number": "1780068221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6846 BUCKLEY ROAD",
            "address_2": "NEPHROLOGY HYPERTENSION ASSOCIATES OF CNY, PC",
            "city": "NORTH SYRACUSE",
            "state": "NY",
            "postal_code": "13212",
            "telephone_number": "315-410-6400",
            "fax_number": "315-410-6410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6846 BUCKLEY ROAD",
            "address_2": "NEPHROLOGY HYPERTENSION ASSOCIATES OF CNY, PC",
            "city": "NORTH SYRACUSE",
            "state": "NY",
            "postal_code": "13212",
            "telephone_number": "315-410-6400",
            "fax_number": "315-410-6410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAVINE",
        "first_name": "LAUREN",
        "middle_name": "E",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-15",
        "last_updated": "2015-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "339783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAUREN",
            "last_name": "GILDEMEYER",
            "middle_name": "E",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in North Syracuse, NY

Sources for this page

Verify at the official NPI Registry.