Individual provider Active NPI

Suzanne P Lagarde, M.D.

  • Gastroenterology Physician
  • New Haven, CT
National Provider Identifier
1114068848
Registry record updated Sep 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
020606 Issued in CT
Practice address
374 Grand Ave
New Haven, CT 06513-3733
Phone
(203) 777-7411
NPI assigned
Feb 8, 2007
Last updated
Sep 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 020606 CT Primary

Addresses

Primary practice location

374 Grand Ave
New Haven, CT 06513-3733

Mailing address

374 Grand Ave
New Haven, CT 06513-3733
Phone (203) 777-7411

Other identifiers 1

IdentifierTypeStateIssuer
001206061MedicaidCT

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090529000300 CT Practitioner - GastroenterologyPractitioner - Internal Medicine 0143398792 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fair Haven Community Health Clinic Inc CurrentSince Jul 2, 2013 Accepting new patients
Connecticut Gastroenterology Consultants, P.C. Gastroenterology Current Accepting new patients
Fair Haven Community Health Clinic, Inc CurrentSince Jun 24, 2013 Accepting new patients
Saint Raphael Healthcare System Affiliated Physicians Inc Past Accepting new patients
Saint Raphael Faculty Physicians Gastroenterology Past Accepting new patients

Locations

374 Grand Ave
New Haven, CT 06513
Phone (203) 752-5203

40 Temple St
Ste 4A
New Haven, CT 06510
Phone (203) 777-0304

Ownership & related parties

All facility ownership & control disclosures 19

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
The Connecticut Hospice IncBranford, CT, CCN 070038 Hospital Corporate Director (100%) Oct 1, 2024
The Connecticut Hospice IncBranford, CT, CCN 077119 Home health agency Corporate Director Oct 1, 2024
The Connecticut Hospice IncBranford, CT, CCN 071500 Hospice Corporate Director Oct 1, 2024
Fair Haven Community Health CenterNew Haven, CT, CCN 071817 Federally qualified health center Corporate Director Jun 24, 2013
Fair Haven Community Health CenterNew Haven, CT, CCN 071805 Federally qualified health center Corporate Officer Jun 24, 2013
Fair Haven Community Health CenterNew Haven, CT, CCN 071807 Federally qualified health center Corporate Officer Jun 24, 2013
Fair Haven Community Health Clinic IncNew Haven, CT, CCN 071899 Federally qualified health center Corporate Director
W-2 Managing Employee
Jun 24, 2013
Jun 24, 2013
Fair Haven Community Health CenterNew Haven, CT, CCN 071806 Federally qualified health center Corporate Officer Jun 24, 2013
Fair Haven Community Health CenterNew Haven, CT, CCN 071900 Federally qualified health center Corporate Director
W-2 Managing Employee
Jun 24, 2013
Jun 24, 2013
Fair Haven Community Health Clinic IncNew Haven, CT, CCN 071909 Federally qualified health center Corporate Director
W-2 Managing Employee
Jun 24, 2013
Jun 24, 2013
Fair Haven Community Health Clinic IncBranford, CT, CCN 071935 Federally qualified health center Corporate Director Jun 24, 2013
Fair Haven Community Health Clinic IncEast Haven, CT, CCN 071936 Federally qualified health center Corporate Director Jun 24, 2013
Fair Haven Community Health Clinic IncEast Haven, CT, CCN 071934 Federally qualified health center Corporate Director (100%)
Operational/Managerial Control (100%)
Jun 20, 2013
Jun 20, 2013
Fair Haven Community Health Clinic IncNew Haven, CT, CCN 071945 Federally qualified health center Corporate Officer
W-2 Managing Employee (100%)
Operational/Managerial Control (100%)
Jun 24, 2013
Jun 24, 2013
Jun 24, 2013
Fair Haven Community Health Clinic IncBranford, CT, CCN 071002 Federally qualified health center Corporate Officer (100%)
W-2 Managing Employee (100%)
Jun 24, 2013
Jun 24, 2013
John B Sliney Elementary SchoolBranford, CT, CCN 071007 Federally qualified health center Corporate Officer (100%)
W-2 Managing Employee (100%)
Jun 24, 2013
Jun 24, 2013
Fair Haven Community Health Care at Bishop Woods SchoolNew Haven, CT, CCN 071006 Federally qualified health center Corporate Officer (100%)
W-2 Managing Employee (100%)
Operational/Managerial Control (100%)
Jun 24, 2013
Jun 24, 2013
Jun 24, 2013
Leeway HouseNew Haven, CT, CCN 071021 Federally qualified health center Corporate Officer
Operational/Managerial Control
Jun 24, 2013
Jun 24, 2013
Ross Woodward School Based Health CenterNew Haven, CT, CCN 071024 Federally qualified health center Corporate Officer (100%) Jun 24, 2013

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 9

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": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725580800000",
    "number": "1114068848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "374 GRAND AVE",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065133733",
            "telephone_number": "203-777-7411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "374 GRAND AVE",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065133733",
            "telephone_number": "203-777-7411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAGARDE",
        "first_name": "SUZANNE",
        "middle_name": "P",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-08",
        "last_updated": "2024-09-06",
        "certification_date": "2024-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CT",
            "license": "020606",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001206061",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.