Individual provider Active NPI

Lauren Marie Whitney, PA-C

  • Surgical Physician Assistant
  • Williamsville, NY
National Provider Identifier
1790181659
Registry record updated Nov 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
17677 Issued in NY
Practice address
5225 Sheridan Dr
Williamsville, NY 14221-3573
Phone
(716) 839-3638
Fax
(716) 839-3102
NPI assigned
Nov 5, 2014
Last updated
Nov 5, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 5, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 17677 NY Primary

Addresses

Primary practice location

5225 Sheridan Dr
Williamsville, NY 14221-3573

Mailing address

5225 Sheridan Dr
Williamsville, NY 14221-3573
Phone (716) 839-3638

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
I20260402001207 NY Practitioner - Physician Assistant 6002391505 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

726 Exchange St
Suite 300
Buffalo, NY 14210-1467

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
17677NYMDSurgical Physician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1415145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415145600000",
    "number": "1790181659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5225 SHERIDAN DR",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142213573",
            "telephone_number": "716-839-3638",
            "fax_number": "716-839-3102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5225 SHERIDAN DR",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142213573",
            "telephone_number": "716-839-3638",
            "fax_number": "716-839-3102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITNEY",
        "first_name": "LAUREN",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-05",
        "last_updated": "2014-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "17677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

Verify at the official NPI Registry.