Individual provider Active NPI

Samuel Lamana, PA

  • Medical Physician Assistant
  • Manchester, CT
National Provider Identifier
1023125598
Registry record updated Nov 15, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
000668 Issued in CT
Practice address
935 Main St
Manchester, CT 06040-6059
Phone
(860) 527-5803
Fax
(860) 525-3687
NPI assigned
Aug 23, 2006
Last updated
Nov 15, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2007

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 000668 CT Primary

Addresses

Primary practice location

935 Main St
Manchester, CT 06040-6059

Mailing address

935 Main St
Watkins Centre
Manchester, CT 06040-6059
Phone (860) 527-5803

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20130506000292 CT Order and Referring Only - Physician Assistant 1951548296

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
000668CTMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Oncology and Blood Disorders, LLP Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: slamana2388491@direct.trinity-health.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195084800000",
    "number": "1023125598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "935 MAIN ST",
            "address_2": "WATKINS CENTRE",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060406059",
            "telephone_number": "860-527-5803",
            "fax_number": "860-524-0645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "935 MAIN ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060406059",
            "telephone_number": "860-527-5803",
            "fax_number": "860-525-3687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAMANA",
        "first_name": "SAMUEL",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2007-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "000668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, CT

Sources for this page

Verify at the official NPI Registry.