Individual provider Active NPI

Larry Stephen Wasser, M.D.

  • Pulmonary Disease Physician
  • Brookfield, CT
National Provider Identifier
1124011457
Registry record updated Sep 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
029504 Issued in CT
Practice address
31 Old Route 7
Ste 1a
Brookfield, CT 06804-1714
Phone
(203) 740-2881
Fax
(203) 740-2111
NPI assigned
Aug 23, 2005
Last updated
Sep 21, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 21, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 029504 CT
Pulmonary Disease Physician 207RP1001X 029504 CT Primary

Addresses

Primary practice location

31 Old Route 7
Ste 1a
Brookfield, CT 06804-1714

Mailing address

31 Old Route 7
Ste 1a
Brookfield, CT 06804-1714
Phone (203) 740-2881

Other identifiers 1

IdentifierTypeStateIssuer
001295048MedicaidCT

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
I20080618000392 CT Practitioner - Pulmonary Disease 5890866842 Practice locations: Brookfield, CT

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Icahn School of Medicine at Mount Sinai, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

31 Old Route 7
Suite 1a
Brookfield, CT 06804-1714
Phone (203) 740-2881

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
029504CTMDCritical Care Medicine (Internal Medicine) Physician
029504NYMDSpeech-Language Pathologist

Interoperability endpoints

  • Direct secure messaging: larry.wasser.1@11729.direct.athenahealth.com

Hospital & facility affiliations 2

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": "1124755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537488000000",
    "number": "1124011457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 OLD ROUTE 7",
            "address_2": "STE 1A",
            "city": "BROOKFIELD",
            "state": "CT",
            "postal_code": "068041714",
            "telephone_number": "203-740-2881",
            "fax_number": "203-740-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 OLD ROUTE 7",
            "address_2": "STE 1A",
            "city": "BROOKFIELD",
            "state": "CT",
            "postal_code": "068041714",
            "telephone_number": "203-740-2881",
            "fax_number": "203-740-2111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASSER",
        "first_name": "LARRY",
        "middle_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-23",
        "last_updated": "2018-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "CT",
            "license": "029504",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CT",
            "license": "029504",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001295048",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookfield, CT

Sources for this page

Verify at the official NPI Registry.