LAURA J. DERYCKE (NPI# 1023056900) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023056900 |
| Entity Type | Individual |
| Full Name | LAURA J. DERYCKE |
| Credential | N.P. |
| Practice Address |
1425 Portland Ave Rochester NY 14621-3001 |
| Practice Telephone | 5859224020 |
| Practice Fax Number | 5859224622 |
| Mailing Telephone | 5859224020 |
| Mailing Fax Number | 5859224622 |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2012-10-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 302186 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 02628893 | 05 |
| Street Address |
1425 PORTLAND AVE |
| City | ROCHESTER |
| State | NY |
| Zip Code | 14621-3001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881697605 | Joseph David Silverberg | Ophthalmology | 1425 Portland Ave, Rochester, NY 14621-3001 | 2005-05-24 |
| 1598372443 | Chengu Niu | Student in an Organized Health Care Education/Training Program | 1425 Portland Ave, Rochester, NY 14621-3011 | 2020-09-24 |
| 1194339085 | Latanya Denise Brown | Licensed Practical Nurse | 1425 Portland Ave, Rochester, NY 14621-3011 | 2020-09-08 |
| 1487267134 | Roberto M Voica | Pharmacist | 1425 Portland Ave, Rochester, NY 14621-3011 | 2020-08-24 |
| 1538770102 | Utsav Joshi | Student in an Organized Health Care Education/Training Program | 1425 Portland Ave, Rochester, NY 14621-3011 | 2020-08-16 |
| 1952911687 | Ido Goldenberg | Student in an Organized Health Care Education/Training Program | 1425 Portland Ave, Rochester, NY 14621-3011 | 2020-08-06 |
| 1669081378 | Carlos Alejandro Portales Castillo | Student in an Organized Health Care Education/Training Program | 1425 Portland Ave, Rochester, NY 14621-3011 | 2020-07-28 |
| 1427667617 | Varun Bhalla | Student in an Organized Health Care Education/Training Program | 1425 Portland Ave, Rochester, NY 14621-3011 | 2020-07-23 |
| 1871101550 | Tamer Salhab Altamimi | Student in an Organized Health Care Education/Training Program | 1425 Portland Ave, Rochester, NY 14621-3011 | 2020-07-17 |
| 1508474628 | Hafsa Faisal | Student in an Organized Health Care Education/Training Program | 1425 Portland Ave, Rochester, NY 14621-3011 | 2020-07-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619515327 | Patti Humphrey | Occupational Therapist | 1831 Ridge Rd. East, Rochester, NY 14621 | 2019-12-12 |
| 1861956682 | Sonya Thomas | Counselor | Sonya Thomas, 490 East Ridge Road, Rochester, NY 14621 | 2019-01-25 |
| 1811478357 | Laura Iannella | Student in an Organized Health Care Education/Training Program | 1455 East Ridge, Rochester, NY 14621 | 2018-08-23 |
| 1982180345 | Naman Sharma | Student in an Organized Health Care Education/Training Program | Rochester General Hospital, 1425 Portland Avenue, Rochester, NY 14621 | 2018-07-18 |
| 1699213447 | Kara Mcallister | Nurse Practitioner | 370 East Ridge Road, Suite 400, Rochester, NY 14621 | 2017-02-01 |
| 1285082982 | Universal Care Services, LLC | In Home Supportive Care | 64 Delamaine Drive, Rochester, NY 14621 | 2016-06-03 |
| 1700243896 | Kenroy King I | Registered Nurse | 67 Warsaw Street, Rochester, NY 14621 | 2016-01-21 |
| 1154794808 | Shari Venisee | Licensed Practical Nurse | 67 Carthage St, Rochester, NY 14621 | 2015-11-03 |
| 1114349024 | Anthony Michael Plavsity | Registered Nurse | 1450 Clifford Ave, Rochester, NY 14621 | 2014-01-11 |
| 1033541107 | The Community Place of Greater Rochester, Inc | Case Management | 500 Carter Street, Rochester, NY 14621 | 2013-07-31 |
| Find all providers in zip 14621 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801406889 | Lauren Reposa | Nurse Practitioner | 420 Snipatuit Rd, Rochester, MA 02770-1843 | 2020-08-05 |
| 1558923599 | Megan Michelle Maurer | Nurse Practitioner | 343 Oakridge Dr, Rochester, NY 14617-2541 | 2019-06-30 |
| 1831674183 | Julie Marie Hammer | Nurse Practitioner | 1415 Portland Ave Ste 220, Rochester, NY 14621-3039 | 2018-10-02 |
| 1417439761 | Andrew Molnar | Nurse Practitioner | 4451 Carriage Hill Ct, Rochester, MI 48306-4672 | 2018-09-04 |
| 1124528740 | Kelly F Dibble | Nurse Practitioner | 222 Alexander St Ste 5000, Rochester, NY 14607-4064 | 2018-02-20 |
| 1255847059 | Brooke Maleszewski | Nurse Practitioner | 821 3rd Ave Se Ste 15, Rochester, MN 55904 | 2017-12-17 |
| 1487163945 | Sylvana Adly Brickley | Nurse Practitioner | 40 Celebration Drive Dermatology, Rochester, NY 14642-0001 | 2017-09-27 |
| 1639603111 | Sos Recovery Services, Inc. | Nurse Practitioner | 234 Adams St, Rochester, PA 15074-2102 | 2017-04-12 |
| 1134534944 | Stephanie Solpietro | Nurse Practitioner | 601 Elmwood Ave Box 619-334, Rochester, NY 14642-0001 | 2014-07-01 |
| 1417200593 | Joann Bettin Trzcinski | Nurse Practitioner | 95 Canal Landing Blvd Ste A, Rochester, NY 14626-5111 | 2012-10-26 |
| Find all providers in ROCHESTER | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.