Individual provider Active NPI

Anthony F Lasala, M.D.

  • Cardiovascular Disease Physician
  • Glastonbury, CT
National Provider Identifier
1114915766
Registry record updated Jun 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
021176 Issued in CT
Practice address
703 Hebron Ave
Glastonbury, CT 06033-5000
Phone
(860) 659-8830
Fax
(860) 633-8529
NPI assigned
Oct 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 021176 CT Primary

Addresses

Primary practice location

703 Hebron Ave
Glastonbury, CT 06033-5000

Mailing address

2110 Silas Deane Hwy
Rocky Hill, CT 06067-2313
Phone (860) 258-3470

Other identifiers 1

IdentifierTypeStateIssuer
001211762MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
021176CTMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiac Care Associates PC Cardiovascular Disease Past Accepting new patients
Consulting Cardiologists, P.C. Cardiovascular Disease PastSince Jul 1, 2001 Accepting new patients
Starling Physicians, PLLC Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
  • FHIR API: https://api.platform.athenahealth.com/6291/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1128643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402012800000",
    "number": "1114915766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2110 SILAS DEANE HWY",
            "city": "ROCKY HILL",
            "state": "CT",
            "postal_code": "060672313",
            "telephone_number": "860-258-3470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 HEBRON AVE",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060335000",
            "telephone_number": "860-659-8830",
            "fax_number": "860-633-8529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LASALA",
        "first_name": "ANTHONY",
        "middle_name": "F",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-07",
        "last_updated": "2014-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CT",
            "license": "021176",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001211762",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glastonbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.