Organization Active NPI

Ann Marie Lago, D.O. PC

  • Family Medicine Physician
  • Sinking Spring, PA
National Provider Identifier
1104095728
Registry record updated Feb 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS012806 Issued in PA
Legal business name
ANN MARIE LAGO, D.O. PC
Practice address
27 Winding Brook Dr
Sinking Spring, PA 19608-9615
Phone
(484) 919-1078
NPI assigned
Feb 28, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2008

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

Authorized official

Name
Dr. Ann Marie Lago, D.O.
Title
President
Phone
(484) 919-1078

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X OS012806 PA Primary

Addresses

Primary practice location

27 Winding Brook Dr
Sinking Spring, PA 19608-9615

Mailing address

27 Winding Brook Dr
Sinking Spring, PA 19608-9615
Phone (484) 919-1078

Other identifiers 1

IdentifierTypeStateIssuer
1013005500001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080411000079 PA Part B Supplier - Clinic/Group Practice 1254418460 Receives reassigned benefits from 1 practitioner
Practice locations: Sinking Spring, PA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1204156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204156800000",
    "number": "1104095728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 WINDING BROOK DR",
            "city": "SINKING SPRING",
            "state": "PA",
            "postal_code": "196089615",
            "telephone_number": "484-919-1078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 WINDING BROOK DR",
            "city": "SINKING SPRING",
            "state": "PA",
            "postal_code": "196089615",
            "telephone_number": "484-919-1078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANN MARIE LAGO, D.O. PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-28",
        "last_updated": "2008-02-28",
        "status": "A",
        "authorized_official_last_name": "LAGO",
        "authorized_official_first_name": "ANN MARIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "484-919-1078",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS012806",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013005500001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sinking Spring, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.