Individual provider Active NPI

Lauren Victoria Manchester, PA

  • Physician Assistant
  • Chester, PA
National Provider Identifier
1831666114
Registry record updated Oct 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1 Medical Center Blvd
Chester, PA 19013-3902
Phone
(610) 447-2000
NPI assigned
Oct 25, 2018
Last updated
Oct 20, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 20, 2022

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

1 Medical Center Blvd
Chester, PA 19013-3902

Mailing address

290 Vaughn Street
Springville, NY 14141
Phone (716) 870-8276

Other practice location 1

290 Vaughn Street
Springville, NY 14141
Phone (716) 870-8276

Other practice location 2

3401 Civic Center Blvd
Philadelphia, PA 19104-4319
Phone (215) 590-1000

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
I20230214002039 NY Practitioner - Physician Assistant 8325410673 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trinity Medical Wny PCGroup PAC ID 5193907517, 207 clinicians

Practice addresses (Care Compare)

2157 Main St
Buffalo, NY 14214-2648
Phone (716) 837-2400

2625 Harlem Rd
Cheektowaga, NY 14225-4031

3435 Bailey Ave
Buffalo, NY 14215-1194
Phone (716) 835-2966

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
029424NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Medical Wny PC Physician Assistant CurrentSince Dec 19, 2022 Accepting new patients
Trinity Medical Wny PC CurrentSince Dec 19, 2022 Accepting new patients

Locations

3435 Bailey Ave
Buffalo, NY 14215
Phone (716) 835-2966

144 Genesee St
Fl 3
Buffalo, NY 14203
Phone (716) 601-3690

2625 Harlem Rd
Ste 240
Cheektowaga, NY 14225
Phone (716) 893-0333

Organizations & group practices 3

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.

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": "1540425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666224000000",
    "number": "1831666114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "290 VAUGHN STREET",
            "city": "SPRINGVILLE",
            "state": "NY",
            "postal_code": "14141",
            "telephone_number": "716-870-8276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER BLVD",
            "city": "CHESTER",
            "state": "PA",
            "postal_code": "190133902",
            "telephone_number": "610-447-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "290 Vaughn Street",
            "address_purpose": "LOCATION",
            "city": "Springville",
            "state": "NY",
            "postal_code": "14141",
            "country_code": "US",
            "telephone_number": "716-870-8276",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3401 Civic Center Blvd",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191044319",
            "country_code": "US",
            "telephone_number": "215-590-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANCHESTER",
        "first_name": "LAUREN",
        "middle_name": "VICTORIA",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-25",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chester, PA

Sources for this page

Verify at the official NPI Registry.