Individual provider Active NPI

Delean Grose Lunger, FNP

  • Adult Health Nurse Practitioner
  • Rochester, NY
National Provider Identifier
1962566158
Registry record updated Jun 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F333699 Issued in NY
Practice address
1415 Portland Ave Ste 245
Rochester, NY 14621
Phone
(585) 922-4715
Fax
(585) 922-3950
NPI assigned
Dec 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F333699 NY Primary

Addresses

Primary practice location

1415 Portland Ave Ste 245
Rochester, NY 14621

Mailing address

100 Kings Hwy S
Rochester, NY 14617-5504
Phone (585) 922-4715

Other practice location 1

821 Pre Emption Rd
Suite 201
Geneva, NY 14456-2061
Phone (315) 325-4858

Other practice location 2

821 Pre Emption Rd
Suite 201
Geneva, NY 14456-2061
Phone (315) 325-4858

Other identifiers 3

IdentifierTypeStateIssuer
02422017MedicaidNY
117342BJOtherNYPREFERRED CARE
P019333699OtherNYBLUE CHOICE

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
I20080604000654 NY Practitioner - Nurse Practitioner 4385714211 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F333699NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rochester General Hospital CurrentSince Jul 1, 2019 Accepting new patients
Rochester General Hospital CurrentSince Jul 1, 2019 Accepting new patients
Beach Medical Services Past Accepting new patients

Locations

200 North St
Ste 101
Geneva, NY 14456
Phone (315) 787-5100

1425 Portland Ave
Rochester, NY 14621
Phone (585) 922-3122

100 Kings Hwy S
Rochester, NY 14617
Phone (585) 922-0553

1415 Portland Ave
Ste 245
Rochester, NY 14621
Phone (585) 922-4715

Organizations & group practices 4

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": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561161600000",
    "number": "1962566158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 KINGS HWY S",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146175504",
            "telephone_number": "585-922-4715",
            "fax_number": "585-922-3950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 PORTLAND AVE STE 245",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "14621",
            "telephone_number": "585-922-4715",
            "fax_number": "585-922-3950"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "821 Pre Emption Rd",
            "address_2": "Suite 201",
            "address_purpose": "LOCATION",
            "city": "Geneva",
            "state": "NY",
            "postal_code": "144562061",
            "country_code": "US",
            "telephone_number": "315-325-4858",
            "fax_number": "518-563-5903",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "821 Pre Emption Rd",
            "address_2": "Suite 201",
            "address_purpose": "LOCATION",
            "city": "Geneva",
            "state": "NY",
            "postal_code": "144562061",
            "country_code": "US",
            "telephone_number": "315-325-4858",
            "fax_number": "518-563-5903",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUNGER",
        "first_name": "DELEAN",
        "middle_name": "GROSE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-21",
        "last_updated": "2019-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F333699",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02422017",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CARE",
            "identifier": "117342BJ",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE",
            "identifier": "P019333699",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.