Individual provider Active NPI

Lars Stangenberg, MD

  • Vascular Surgery Physician
  • Providence, RI
National Provider Identifier
1003077090
Registry record updated Feb 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
MD15584 Issued in RI
Practice address
2 Dudley St
Suite 470
Providence, RI 02905-3236
Phone
(401) 553-8318
Fax
(401) 868-2307
NPI assigned
Jun 23, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 254554 MA
Diagnostic Radiology Physician 2085R0202X L-236269 MA
Vascular Surgery Physician 2086S0129X MD15584 RI Primary

Addresses

Primary practice location

2 Dudley St
Suite 470
Providence, RI 02905-3236

Mailing address

PO Box 24300
New York, NY 10087-4300

Other practice location 1

680 Centre St
Brockton, MA 02302-3308
Phone (508) 941-7000

Other practice location 2

110 Liberty St
Brockton, MA 02301-5674
Phone (508) 565-0452

Other practice location 3

41 Highland Ave
Winchester, MA 01890-1446
Phone (781) 729-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200309002602 MA Practitioner - Vascular Surgery 9032372511 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr IncGroup PAC ID 4486567104, shared by 12 NPIs, 1,693 clinicians
Signature Healthcare Medical Group IncGroup PAC ID 7719876267, 250 clinicians

Practice addresses (Care Compare)

1 Deaconess Rd
Boston, MA 02215-5321
Phone (781) 983-9088

110 Liberty St
Brockton, MA 02301-5521
Phone (508) 894-0400

114 N Beacon St
Suite 116
Brighton, MA 02135-2011
Phone (781) 983-9088

116 N Beacon St
Brighton, MA 02135-2011
Phone (617) 783-5200

275 Sandwich St
Plymouth, MA 02360-2183
Phone (781) 983-9088

330 Brookline Ave
Boston, MA 02215-5400

330 Mount Auburn St
Cambridge, MA 02138-5502
Phone (781) 983-9088

41 Highland Ave
Winchester, MA 01890-1446
Phone (781) 983-9088

600 Unicorn Park Dr
Woburn, MA 01801-3376

Hospital & facility affiliations

  • Beth Israel Deaconess Medical Center Hospital, Boston, MA, CCN 220086
  • Signature Healthcare Brockton Hospital Hospital, Brockton, MA, CCN 220052
  • Mount Auburn Hospital Hospital, Cambridge, MA, CCN 220002
  • Beth Israel Deaconess Hospital - Needham Hospital, Needham, MA, CCN 220083
  • Beth Israel Deaconess Hospital Plymouth Hospital, Plymouth, MA, CCN 220060

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion13
Varicose vein removal1-10
Leg revascularization (restoring blood flow)18
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
L-236269MAMDDiagnostic Radiology Physician
254554MAMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Aug 1, 2025 Accepting new patients
Signature Healthcare Medical Group Inc CurrentSince Jun 2, 2025 Accepting new patients
Beth Israel Lahey Health Specialty Care, Inc. CurrentSince Jan 19, 2026 Accepting new patients
Beth Israel Lahey Health Specialty Care, Inc. CurrentSince Jan 19, 2026 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Feb 1, 2020 Accepting new patients
Mount Auburn Professional Services Inc Vascular Surgery CurrentSince Jun 1, 2022 Accepting new patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Feb 1, 2020 Accepting new patients
Mt Auburn Professional Services CurrentSince Jun 1, 2022 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc Vascular Surgery CurrentSince Feb 1, 2020 Accepting new patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Feb 1, 2020 Accepting new patients

Locations

330 Brookline Ave
Boston, MA 02215
Phone (617) 667-2000

110 Liberty St
Brockton, MA 02301

680 Centre St
Brockton, MA 02302
Phone (508) 941-7400

41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8400

57 Bedford St
Ste 130
Lexington, MA 02420
Phone (781) 484-7500

247 Station Dr
Ste NW1
Westwood, MA 02090
Phone (617) 754-1015

41 Highland Ave
Winchester, MA 01890
Phone (781) 756-2000

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/86/brand/1/csg/1/fhir/r4
  • Direct secure messaging: lstangenberg251712@direct.bilh.masshiway.net
  • Direct secure messaging: lars.stangenberg@direct.signature.masshiway.net

Organizations & group practices 10

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1214179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770595200000",
    "number": "1003077090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 24300",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100874300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 DUDLEY ST",
            "address_2": "SUITE 470",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029053236",
            "telephone_number": "401-553-8318",
            "fax_number": "401-868-2307"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "680 Centre St",
            "address_purpose": "LOCATION",
            "city": "Brockton",
            "state": "MA",
            "postal_code": "023023308",
            "country_code": "US",
            "telephone_number": "508-941-7000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "110 Liberty St",
            "address_purpose": "LOCATION",
            "city": "Brockton",
            "state": "MA",
            "postal_code": "023015674",
            "country_code": "US",
            "telephone_number": "508-565-0452",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "41 Highland Ave",
            "address_purpose": "LOCATION",
            "city": "Winchester",
            "state": "MA",
            "postal_code": "018901446",
            "country_code": "US",
            "telephone_number": "781-729-2020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STANGENBERG",
        "first_name": "LARS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-23",
        "last_updated": "2026-02-09",
        "certification_date": "2026-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "MA",
            "license": "254554",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "L-236269",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "RI",
            "license": "MD15584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.