Individual provider Active NPI

Cristen Lyn Laird, D.O.

  • Surgery Physician
  • Trenton, MI
National Provider Identifier
1023284981
Registry record updated Dec 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
5101017734 Issued in MI
Practice address
2128 W Jefferson Ave
Trenton, MI 48183-5470
Phone
(734) 307-3040
Fax
(734) 818-5714
NPI assigned
May 1, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 5101017734 MI Primary

Addresses

Primary practice location

2128 W Jefferson Ave
Trenton, MI 48183-5470

Mailing address

1405 13TH St
Wyandotte, MI 48192-3335
Phone (734) 307-3040

Other names 1

  • Dr. Cristen Lyn Dahl-Fulton Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cristenlyn.laird@116466729484292.direct.elationemr.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20130911000806 MI Practitioner - General Surgery 9032353180 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Laird and Laird Surgical Associates PLLCGroup PAC ID 9133465644, 2 clinicians

Practice addresses (Care Compare)

2128 W Jefferson Ave
Suite 101
Trenton, MI 48183-5470
Phone (734) 307-3040

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy17
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Laird and Laird Surgical Associates, PLLC Surgery CurrentSince Jul 24, 2018 Accepting new patients

Locations

2128 W Jefferson Ave
Ste 101
Trenton, MI 48183
Phone (734) 307-3040

2128 W Jefferson Ave
Trenton, MI 48183
Phone (734) 676-4040

5450 Fort St
Woodhaven, MI 48183
Phone (734) 671-3297

Interoperability endpoints

  • Direct secure messaging: claird@lakeshoresurgical.ssdirect.aprima.com
  • Direct secure messaging: cristenlyn.laird@116466729484292.direct.elationemr.com
  • Direct secure messaging: claird14240@direct.hfhs.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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1209600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608076800000",
    "number": "1023284981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 13TH ST",
            "city": "WYANDOTTE",
            "state": "MI",
            "postal_code": "481923335",
            "telephone_number": "734-307-3040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2128 W JEFFERSON AVE",
            "city": "TRENTON",
            "state": "MI",
            "postal_code": "481835470",
            "telephone_number": "734-307-3040",
            "fax_number": "734-818-5714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAIRD",
        "first_name": "CRISTEN",
        "middle_name": "LYN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-01",
        "last_updated": "2020-12-16",
        "certification_date": "2020-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "5101017734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cristenlyn.laird@116466729484292.direct.elationemr.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2128 W Jefferson Ave",
            "city": "Trenton",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481835470",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CRISTEN",
            "last_name": "DAHL-FULTON",
            "middle_name": "LYN",
            "prefix": "DR.",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Trenton, MI

Sources for this page

Verify at the official NPI Registry.