Individual provider Active NPI

Eric Lehnert, ATC, FNP-C

  • Family Nurse Practitioner
  • Nesconset, NY
National Provider Identifier
1780646125
Registry record updated Aug 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
340699 Issued in NY
Practice address
55 Southern Blvd
Nesconset, NY 11767-1043
Phone
(631) 361-3363
Fax
(631) 361-3579
NPI assigned
Apr 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X
Family Nurse Practitioner 363LF0000X 340699 NY Primary

Addresses

Primary practice location

55 Southern Blvd
Nesconset, NY 11767-1043

Mailing address

27 Marion Dr
Lake Ronkonkoma, NY 11779-3007
Phone (631) 467-4722

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
I20170208002063 NY Order and Referring Only - Nurse Practitioner 8628351087

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
340699NYMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471392000000",
    "number": "1780646125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 MARION DR",
            "city": "LAKE RONKONKOMA",
            "state": "NY",
            "postal_code": "117793007",
            "telephone_number": "631-467-4722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 SOUTHERN BLVD",
            "city": "NESCONSET",
            "state": "NY",
            "postal_code": "117671043",
            "telephone_number": "631-361-3363",
            "fax_number": "631-361-3579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEHNERT",
        "first_name": "ERIC",
        "credential": "ATC, FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-03",
        "last_updated": "2016-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "340699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nesconset, NY

Sources for this page

Verify at the official NPI Registry.