Individual provider Active NPI

Laura London, PA-C

  • Physician Assistant
  • Bridgeport, CT
National Provider Identifier
1225780653
Registry record updated Jan 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5559 Issued in CT
Practice address
254 Sunrise Ter
Bridgeport, CT 06606-2703
Phone
(203) 873-9737
NPI assigned
Jan 26, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5559 CT Primary

Addresses

Primary practice location

254 Sunrise Ter
Bridgeport, CT 06606-2703

Mailing address

254 Sunrise Ter
Bridgeport, CT 06606-2703
Phone (203) 873-9737

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
I20220729002078 CT Practitioner - Physician Assistant 6305228867 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Urgent Care Medical Associates, LLCGroup PAC ID 7214107515, 113 clinicians
Westport Urgent Care LLCGroup PAC ID 4688826712, 7 clinicians

Practice addresses (Care Compare)

1040 Barnum Ave
Stratford, CT 06614-4968
Phone (860) 650-3848

1045 Post E Rd
Westport, CT 06880-5370
Phone (203) 557-8200

266 S Main St
Newtown, CT 06470-6706
Phone (860) 650-3848

340 Grasmere Ave
Fairfield, CT 06824-6155
Phone (860) 650-3848

346 Main Ave
Norwalk, CT 06851-1592
Phone (860) 650-3848

78 Pershing Dr
Derby, CT 06418-1433
Phone (860) 650-3848

900 Main St S
Suite 100
Southbury, CT 06488-4213
Phone (860) 650-3848

920 Wolcott St
Suite 19
Waterbury, CT 06705-1300
Phone (860) 650-3848

Hospital & facility affiliations

  • Bridgeport Hospital Hospital, Bridgeport, CT, CCN 070010

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
WRK Ventures, LLC Past Accepting new patients
QMG7,LLC Past Accepting new patients

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 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": "1643155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643155200000",
    "number": "1225780653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "254 SUNRISE TER",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066062703",
            "telephone_number": "203-873-9737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "254 SUNRISE TER",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066062703",
            "telephone_number": "203-873-9737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONDON",
        "first_name": "LAURA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-26",
        "last_updated": "2022-01-26",
        "certification_date": "2022-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "5559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, CT

Sources for this page

Verify at the official NPI Registry.