Individual provider Active NPI

Andrea Lagasse, PA-C

  • Surgical Physician Assistant
  • Manchester, CT
National Provider Identifier
1124383112
Registry record updated Nov 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
2766 Issued in CT
Practice address
71 Haynes St
Manchester, CT 06040-4131
Phone
(401) 837-1018
NPI assigned
Jul 6, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 2766 CT Primary

Addresses

Primary practice location

71 Haynes St
Manchester, CT 06040-4131

Mailing address

20 Greenmeadow LN
Granby, MA 01033-9594
Phone (401) 837-1018

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, MA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20120809000214 CT Practitioner - Physician Assistant 4981850815 Reassigns benefits to 1 organization
I20140801001915 MA Practitioner - Physician Assistant 4981850815 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baystate Medical Practices IncGroup PAC ID 5991602971, 1,350 clinicians
Riverbend Medical Group IncGroup PAC ID 5698064343, 227 clinicians

Practice addresses (Care Compare)

100 Wason Ave
Springfield, MA 01107-1381
Phone (413) 788-6139

233 Carew St
Springfield, MA 01104-2377
Phone (413) 748-9212

271 Carew St
Springfield, MA 01104-2377
Phone (413) 748-9000

280 Chestnut St
Suite 2
Springfield, MA 01199-1001

759 Chestnut St
Springfield, MA 01199-1001
Phone (413) 794-5439

Hospital & facility affiliations

  • Baystate Medical Center Hospital, Springfield, MA, CCN 220077
  • Mercy Medical Ctr Hospital, Springfield, MA, CCN 220066

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Riverbend Medical Group, Inc CurrentSince Jun 1, 2021 Accepting new patients
Eastern Connecticut Medical Professionals Foundation Inc Past Accepting new patients
Mwa,PC Past Accepting new patients

Locations

233 Carew St
#101
Springfield, MA 01104
Phone (413) 748-9212

271 Carew St
Springfield, MA 01104
Phone (413) 748-9000

Interoperability endpoints

  • Direct secure messaging: alagasse2386221@direct.trinity-health.org

Organizations & group practices 7

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 4

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": "1341532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416873600000",
    "number": "1124383112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 GREENMEADOW LN",
            "city": "GRANBY",
            "state": "MA",
            "postal_code": "010339594",
            "telephone_number": "401-837-1018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 HAYNES ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060404131",
            "telephone_number": "401-837-1018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAGASSE",
        "first_name": "ANDREA",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-06",
        "last_updated": "2014-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CT",
            "license": "2766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, CT

Sources for this page

Verify at the official NPI Registry.