Individual provider Active NPI

Julie Lauren Laifer, MD

  • Obstetrics & Gynecology Physician
  • Southport, CT
National Provider Identifier
1174614879
Registry record updated Jan 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
035758 Issued in CT
Practice address
2600 Post Rd
Suite 1L
Southport, CT 06890-1258
Phone
(203) 254-3886
Fax
(203) 254-3472
NPI assigned
Sep 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 035758 CT Primary

Addresses

Primary practice location

2600 Post Rd
Suite 1L
Southport, CT 06890-1258

Mailing address

27 Spriteview Ave
Westport, CT 06880
Phone (203) 454-4818

Other identifiers 1

IdentifierTypeStateIssuer
001357584MedicaidCT

Other names 1

  • Julie Lauren Gluck Former name

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
I20070705000107 CT Practitioner - Obstetrics/Gynecology 7911007927 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Vermont College of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeast Medical Group IncGroup PAC ID 1254233836, 1,357 clinicians

Practice addresses (Care Compare)

95 Armory Rd
Stratford, CT 06614-1702
Phone (203) 384-3388

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
86.54
Promoting interoperability
99.98
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
035758CTMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mill Hill Medical Consultants Inc CurrentSince May 26, 2010 Accepting new patients
Northeast Medical Group, Inc. Obstetrics & Gynecology CurrentSince May 26, 2010 Accepting new patients

Locations

226 Mill Hill Ave
Ste 3
Bridgeport, CT 06610
Phone (203) 384-3394

226 Mill Hill Ave
Bridgeport, CT 06610
Phone (203) 384-3235

2600 Post Rd
Ste 1L
Southport, CT 06890
Phone (203) 254-3886

95 Armory Rd
Stratford, CT 06614
Phone (203) 384-3388

Interoperability endpoints

  • Direct secure messaging: jlaifer42687@direct.ynhh.org

Organizations & group practices 2

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 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": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421712000000",
    "number": "1174614879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 SPRITEVIEW AVE",
            "city": "WESTPORT",
            "state": "CT",
            "postal_code": "06880",
            "telephone_number": "203-454-4818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 POST RD",
            "address_2": "SUITE 1L",
            "city": "SOUTHPORT",
            "state": "CT",
            "postal_code": "068901258",
            "telephone_number": "203-254-3886",
            "fax_number": "203-254-3472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAIFER",
        "first_name": "JULIE",
        "middle_name": "LAUREN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2015-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CT",
            "license": "035758",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001357584",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JULIE",
            "last_name": "GLUCK",
            "middle_name": "LAUREN",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Southport, CT

Sources for this page

Verify at the official NPI Registry.