Individual provider Active NPI

Lauren Renee Sauvageau, PA-C

  • Medical Physician Assistant
  • Lockport, NY
National Provider Identifier
1922617414
Registry record updated Jul 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
024996 Issued in NY
Practice address
77 Elizabeth Dr
Lockport, NY 14094-5226
Phone
(716) 433-2674
NPI assigned
Jul 30, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 024996 NY Primary

Addresses

Primary practice location

77 Elizabeth Dr
Lockport, NY 14094-5226

Mailing address

77 Elizabeth Dr
Lockport, NY 14094-5226
Phone (716) 433-2674

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
I20201029001074 NY Practitioner - Physician Assistant 0840600078 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
024996NYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ub Family Medicine, Inc PastSince Mar 1, 2026 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1596067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596067200000",
    "number": "1922617414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 ELIZABETH DR",
            "city": "LOCKPORT",
            "state": "NY",
            "postal_code": "140945226",
            "telephone_number": "716-433-2674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 ELIZABETH DR",
            "city": "LOCKPORT",
            "state": "NY",
            "postal_code": "140945226",
            "telephone_number": "716-433-2674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAUVAGEAU",
        "first_name": "LAUREN",
        "middle_name": "RENEE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-30",
        "last_updated": "2020-07-30",
        "certification_date": "2020-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "024996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lockport, NY

Sources for this page

Verify at the official NPI Registry.