Active NPI
Jennifer Adele Lukomski, PH.D.
- Psychologist
- Fairport, NY
National Provider Identifier
1942301346
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- O13343
- Practice address
- 620 Crosskeys Office Park
Fairport, NY 14450-3508 - Phone
- (585) 223-5920
- Fax
- (585) 223-5727
- NPI assigned
- Sep 26, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | O13343 | NY | Primary |
Addresses
Primary practice location
620 Crosskeys Office Park
Fairport, NY 14450-3508
Mailing address
620 Crosskeys Office Park
Fairport, NY 14450-3508
Phone (585) 223-5920
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P010013343 | Other | NY | BLUE CHOICE |
| P020013343 | Other | NY | BLUE CROSS BLUE SHIELD |
| 7202631 | Medicaid | NY | |
| 112174FC | Other | NY | PREFERRED CARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| O13343 | NY | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rochester Psychological Associates PLLC | Psychologist | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Psychologist
- Fairport, NY
- NPI 1144304502
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1334880000000",
"number": "1942301346",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "620 CROSSKEYS OFFICE PARK",
"city": "FAIRPORT",
"state": "NY",
"postal_code": "144503508",
"telephone_number": "585-223-5920",
"fax_number": "585-223-5727"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "620 CROSSKEYS OFFICE PARK",
"city": "FAIRPORT",
"state": "NY",
"postal_code": "144503508",
"telephone_number": "585-223-5920",
"fax_number": "585-223-5727"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUKOMSKI",
"first_name": "JENNIFER",
"middle_name": "ADELE",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-26",
"last_updated": "2012-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "O13343",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CHOICE",
"identifier": "P010013343",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "P020013343",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7202631",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED CARE",
"identifier": "112174FC",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fairport, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.