Individual provider Active NPI

Michelle Lavallee Dagostine, M.D.

  • Neurology Physician
  • Cheshire, CT
National Provider Identifier
1205086733
Registry record updated Jun 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
048766 Issued in CT
Practice address
280 South Main Street
Suite 102
Cheshire, CT 06410
Phone
(860) 870-6385
NPI assigned
Sep 20, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X MD037405 DC
Neurology Physician 2084N0400X 48766 CT
Neurology Physician 2084N0400X 0101246055 VA
Neurology Physician 2084N0400X 048766 CT Primary

Addresses

Primary practice location

280 South Main Street
Suite 102
Cheshire, CT 06410

Mailing address

280 South Main Street
Suite 102
Cheshire, CT 06410
Phone (860) 870-6385

Other names 1

  • Dr. Michelle Marie Lavallee 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
I20101101001092 CT Practitioner - Neurology 0446444681 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Georgetown University School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hartford Healthcare Medical Group Specialists PLLCGroup PAC ID 3173866241, 1,555 clinicians

Practice addresses (Care Compare)

455 Lewis Ave
Meriden, CT 06451-2121
Phone (203) 694-7595

Hospital & facility affiliations

  • Hartford Hospital Hospital, Hartford, CT, CCN 070025

Merit-based Incentive Payment System (MIPS)

Final score
90.42 of 100Reported as group
Quality
83.36
Promoting interoperability
100
Improvement activities
40
Cost
75.9

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy14

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD037405DCMDNeurology Physician
0101246055VAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Healthcare Medical Group Specialists, PLLC Neurology CurrentSince Jun 1, 2019 Accepting new patients
Danbury Hospital Current Accepting new patients
Danbury Hospital CurrentSince Dec 11, 2011 Accepting new patients
Hartford Healthcare Medical Group, Inc Neurology CurrentSince Jul 15, 2017 Accepting new patients
Hartford Healthcare Medical Group Specialists LLC CurrentSince Jun 1, 2019 Accepting new patients

Locations

280 S Main St
Ste 102
Cheshire, CT 06410
Phone (203) 224-5161

20 Germantown Rd
Danbury, CT 06810
Phone (203) 739-4820

455 Lewis Ave
Ste 221
Meriden, CT 06451
Phone (203) 694-7595

55 Meriden Ave
Ste 1D
Southington, CT 06489
Phone (860) 276-5144

1244 Storrs Rd
Storrs Mansfield, CT 06268
Phone (860) 724-2579

1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977

Interoperability endpoints

  • Direct secure messaging: michellel.dagostine@xdr.hhchealthdirect.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 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": "1221868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655942400000",
    "number": "1205086733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 SOUTH MAIN STREET",
            "address_2": "SUITE 102",
            "city": "CHESHIRE",
            "state": "CT",
            "postal_code": "06410",
            "telephone_number": "860-870-6385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 SOUTH MAIN STREET",
            "address_2": "SUITE 102",
            "city": "CHESHIRE",
            "state": "CT",
            "postal_code": "06410",
            "telephone_number": "860-870-6385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAGOSTINE",
        "first_name": "MICHELLE",
        "middle_name": "LAVALLEE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-20",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "DC",
            "license": "MD037405",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CT",
            "license": "48766",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "VA",
            "license": "0101246055",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CT",
            "license": "048766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "LAVALLEE",
            "middle_name": "MARIE",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cheshire, CT

Sources for this page

Verify at the official NPI Registry.