Individual provider Active NPI

Michelle Marie Lachance, PA

  • Medical Physician Assistant
  • Waterbury, CT
National Provider Identifier
1154357671
Registry record updated Sep 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
001383 Issued in CT
Practice address
56 Franklin St
Waterbury, CT 06706-1221
Phone
(203) 709-6004
Fax
(203) 709-3700
NPI assigned
Jun 25, 2006
Last updated
Sep 12, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 001383 CT Primary

Addresses

Primary practice location

56 Franklin St
Waterbury, CT 06706-1221

Mailing address

56 Franklin St
3Rd Floor
Waterbury, CT 06706-1221
Phone (203) 709-8873

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040303000497 CT Practitioner - Physician Assistant 3173410198 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trinity Health of New England Urgent Care PLLCGroup PAC ID 9436561388, 10 clinicians
Neighborhood Health, Inc.Group PAC ID 6204977218, 9 clinicians

Practice addresses (Care Compare)

1312 W Main St
Waterbury, CT 06708-3121
Phone (203) 709-4030

2800 Main St
Bridgeport, CT 06606-4201
Phone (203) 576-5085

58 Maple St
Naugatuck, CT 06770-4160
Phone (203) 723-5636

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
001383CTMDAdult Psychiatric/Mental Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Midstate Medical Group, PC Past Accepting new patients
Franklin Medical Group, PC Past Accepting new patients
Long River Physicians, LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mlachance2413428@direct.trinity-health.org

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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": "1151193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189555200000",
    "number": "1154357671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56 FRANKLIN ST",
            "address_2": "3RD FLOOR",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067061221",
            "telephone_number": "203-709-8873",
            "fax_number": "203-709-8689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 FRANKLIN ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067061221",
            "telephone_number": "203-709-6004",
            "fax_number": "203-709-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACHANCE",
        "first_name": "MICHELLE",
        "middle_name": "MARIE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-25",
        "last_updated": "2007-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "001383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

Verify at the official NPI Registry.