Individual provider Active NPI

Ikuko Laccheo, M.D.

  • Neurology Physician
  • Williamsburg, VA
National Provider Identifier
1255539797
Registry record updated Oct 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
0101254625 Issued in VA
Practice address
400 Sentara Cir Ste 201C
Williamsburg, VA 23188-5716
Phone
(757) 345-4490
NPI assigned
Jul 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 0101254625 VA Primary

Addresses

Primary practice location

400 Sentara Cir Ste 201C
Williamsburg, VA 23188-5716

Mailing address

10275 Little Patuxent Pkwy Ste 300
Columbia, MD 21044-3445
Phone (888) 464-2466

Other practice location 1

229 William Claiborne
Williamsburg, VA 23185-6528
Phone (888) 464-2466

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20150724011712 VA Practitioner - Neurology 2466618640 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
University of Kansas School of Med (KC/Wich/Sal), 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sentara Medical GroupGroup PAC ID 8921903923, 1,396 clinicians

Practice addresses (Care Compare)

400 Sentara Cir
Suite 201C
Williamsburg, VA 23188-5716
Phone (757) 736-1520

Hospital & facility affiliations

  • Sentara Home Care Services-Williamsburg Home health agency, Williamsburg, VA, CCN 497748
  • Sentara Williamsburg Regional Medical Center Hospital, Williamsburg, VA, CCN 490066
  • Sentara Careplex Hospital Hospital, Hampton, VA, CCN 490093
  • Sentara Obici Hospital Hospital, Suffolk, VA, CCN 490044
  • Sentara Leigh Hospital Hospital, Norfolk, VA, CCN 490046
  • Sentara Norfolk General Hospital Hospital, Norfolk, VA, CCN 490007

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: ilaccheo27712@direct.xtensys.com

Organizations & group practices 1

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 7

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": "1183593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729728000000",
    "number": "1255539797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10275 LITTLE PATUXENT PKWY STE 300",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210443445",
            "telephone_number": "888-464-2466",
            "fax_number": "410-740-1518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 SENTARA CIR STE 201C",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231885716",
            "telephone_number": "757-345-4490"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "229 William Claiborne",
            "address_purpose": "LOCATION",
            "city": "Williamsburg",
            "state": "VA",
            "postal_code": "231856528",
            "country_code": "US",
            "telephone_number": "888-464-2466",
            "fax_number": "410-740-1518",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LACCHEO",
        "first_name": "IKUKO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-05",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "VA",
            "license": "0101254625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsburg, VA

Sources for this page

Verify at the official NPI Registry.