Individual provider Active NPI

Lawrence Ogweno Olala, PA

  • Physician Assistant
  • Danbury, CT
National Provider Identifier
1265904627
Registry record updated Jan 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4370 Issued in CT
Practice address
24 Hospital Ave
Danbury, CT 06810-6099
Phone
(203) 789-7100
NPI assigned
Dec 26, 2018
Last updated
Jan 28, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 4370 CT Primary
Physician Assistant 363A00000X

Addresses

Primary practice location

24 Hospital Ave
Danbury, CT 06810-6099

Mailing address

89 Florence Rd
Branford, CT 06405-4246

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
I20190228001364 CT Practitioner - Physician Assistant 4385983824 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Yale University School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Afc Physicians of Connecticut PCGroup PAC ID 5193966893, 39 clinicians
North Shore Lij Urgent Care PCGroup PAC ID 6002131778, 389 clinicians

Practice addresses (Care Compare)

100 Mill Plain Rd
Danbury, CT 06811-5178
Phone (203) 826-2140

1011 High Ridge Rd
Suite 101
Stamford, CT 06905-1604
Phone (475) 477-2330

1953 Black Rock Tpke
Fairfield, CT 06825-3506
Phone (475) 273-8590

2 Main St
Danbury, CT 06810-8047
Phone (203) 826-2140

205 Main St
Suite 7
Norwalk, CT 06851-3530
Phone (475) 257-6057

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4370CTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Afc Physicians of Connecticut, PC CurrentSince Sep 1, 2020 Accepting new patients
Norwalk Hospital Association CurrentSince Mar 1, 2020 Accepting new patients
Danbury Hospital CurrentSince Apr 1, 2019 Accepting new patients
Norwalk Hospital Association CurrentSince Mar 1, 2020 Accepting new patients

Locations

2 Main St
Danbury, CT 06810
Phone (203) 826-2140

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

24 Hospital Ave
Danbury, CT 06810
Phone (203) 739-7118

520 West Ave
Norwalk, CT 06850
Phone (203) 852-2417

Interoperability endpoints

  • Direct secure messaging: lawrence.olala@ghuc.eclinicaldirectplus.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1545782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548633600000",
    "number": "1265904627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "89 FLORENCE RD",
            "city": "BRANFORD",
            "state": "CT",
            "postal_code": "064054246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 HOSPITAL AVE",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068106099",
            "telephone_number": "203-789-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLALA",
        "first_name": "LAWRENCE",
        "middle_name": "OGWENO",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-12-26",
        "last_updated": "2019-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "4370",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danbury, CT

Sources for this page

Verify at the official NPI Registry.