Lisa Wallenfels, NP

Primary specialty

Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X

License

420426 Issued in NY

Practice address

1360 N Forest Rd
Ste 102
Williamsville, NY 14221-1200

Phone

(716) 639-4034

Fax

(716) 639-7814

NPI assigned

Feb 19, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

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

Specialty

Nurse Practitioner

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Audubon Women's Medical Associates, PCGroup PAC ID 9739083163, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lwallenfels@audubonwomens.medentdirect.com

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.

• Audubon Women's Medical Associates, PC

  • Obstetrics & Gynecology Physician
  • Williamsville, NY
  • NPI 1770625600
  Medicare reassignment Care Compare group NPD
• Lori Badach,LCSW, PLLC

  • Community/Behavioral Health Agency
  • Williamsville, NY
  • NPI 1548772312
  NPD (past)

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569542400000",
    "number": "1891839064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2240 NORTH FOREST RD.",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "14221",
            "telephone_number": "716-639-4034",
            "fax_number": "716-639-7814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1360 N FOREST RD",
            "address_2": "STE 102",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142211200",
            "telephone_number": "716-639-4034",
            "fax_number": "716-639-7814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLENFELS",
        "first_name": "LISA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-19",
        "last_updated": "2019-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "NY",
            "license": "F420426",
            "primary": false
        },
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "NY",
            "license": "420426",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000560362003",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IHA",
            "identifier": "9512212",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jenice Walker
• Mary D Walker, PHARMD
• Shermika Walker, LPN
• Tammy Walker, RN
• Darcy Frances Wallen, LCSW
• Ryan Walsh
• Walter D Hoffman,MDPC
• Amanda Beth Walter, SLP/L
• Lonny G Walter, M.D.
• Carter Lynne Wanamaker, FNP-BC

• Obstetrics & Gynecology Nurse Practitioner in Williamsville, NY
• Providers in Williamsville, NY by specialty
• Obstetrics & Gynecology Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.