Individual provider Active NPI

Hanati Tarwrisa Lubega

  • Gerontology Nurse Practitioner
  • Methuen, MA
National Provider Identifier
1174820245
Registry record updated Jul 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
RN265499 Issued in MA
Practice address
12 Ingalls CT
Methuen, MA 01844-3712
Phone
(978) 996-9698
NPI assigned
Feb 24, 2011
Last updated
Jul 7, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X RN265499 MA Primary

Addresses

Primary practice location

12 Ingalls CT
Methuen, MA 01844-3712

Mailing address

12 Ingalls CT
Methuen, MA 01844-3712
Phone (978) 996-9698

Other names 1

  • Ms. Hanati Tarwrisa Lubega Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, CT2 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
I20110707000216 MA Practitioner - Nurse Practitioner 9234317686 Reassigns benefits to 1 organization
I20240314002067 CT Practitioner - Nurse Practitioner 9234317686 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Reliant Housecalls, PLLCGroup PAC ID 4284174228, 17 clinicians

Practice addresses (Care Compare)

30 Lafayette SQ
Suite 30
Vernon, CT 06066-4554
Phone (800) 391-0599

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
8268CTMDProfessional Counselor
RN265499MAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
HDC Care Solutions, LLC Gerontology CurrentSince Jan 2, 2025 Accepting new patients
Value Based Long Term Care H PC CurrentSince May 1, 2025 Accepting new patients
Healthdrive Medical Services Southeast LLC Gerontology CurrentSince Aug 1, 2025 Accepting new patients
Careconnectmd Connecticut PC CurrentSince Jan 16, 2025 Accepting new patients
Reliant Housecalls, PLLC CurrentSince Jan 1, 2026 Accepting new patients
Signify Health Medical Associates, PLLC CurrentSince Feb 4, 2024 Accepting new patients

Locations

3090 Bristol St
Ste 200
Costa Mesa, CA 92626
Phone (714) 992-1182

101 Centerpoint Dr
Ste 215
Middletown, CT 06457
Phone (203) 696-3550

175 Capital Blvd
Fl 4
Rocky Hill, CT 06067
Phone (860) 380-0452

5 Research Dr
Shelton, CT 06484
Phone (203) 567-5264

1266 E Main St
Stamford, CT 06902
Phone (203) 276-3000

30 Lafayette Sq
Ste 30
Vernon, CT 06066
Phone (800) 391-0599

30 Lafayette Sq
Ste 109
Vernon Rockville, CT 06066
Phone (800) 391-0599

155 Federal St
Ste 700
Boston, MA 02110
Phone (469) 466-7420

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Organizations & group practices 6

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": "1298505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436227200000",
    "number": "1174820245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 INGALLS CT",
            "city": "METHUEN",
            "state": "MA",
            "postal_code": "018443712",
            "telephone_number": "978-996-9698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 INGALLS CT",
            "city": "METHUEN",
            "state": "MA",
            "postal_code": "018443712",
            "telephone_number": "978-996-9698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUBEGA",
        "first_name": "HANATI",
        "middle_name": "TARWRISA",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-02-24",
        "last_updated": "2015-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MA",
            "license": "RN265499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HANATI",
            "last_name": "LUBEGA",
            "middle_name": "TARWRISA",
            "prefix": "MS.",
            "credential": "NP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Methuen, MA

Sources for this page

Verify at the official NPI Registry.