Individual provider Active NPI

Lalaine Mortera, M.D.

  • Pediatrics Physician
  • Southbury, CT
National Provider Identifier
1275541781
Registry record updated Jul 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
035458 Issued in CT
Practice address
22 Old Waterbury Rd
Suite 204
Southbury, CT 06488-3848
Phone
(203) 262-4250
NPI assigned
Aug 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 035458 CT Primary

Addresses

Primary practice location

22 Old Waterbury Rd
Suite 204
Southbury, CT 06488-3848

Mailing address

22 Old Waterbury Rd
Suite 204
Southbury, CT 06488-3848
Phone (203) 262-4250

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20190805001120 NY Practitioner - Pediatric Medicine 5395072060 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
035458CTMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Boston Children's Health Physicians, LLP Pediatrics CurrentSince Aug 1, 2019 Accepting new patients
Boston Childrens Health Physicians LLP CurrentSince Aug 1, 2019 Accepting new patients
Nuvance Health Medical Practice CT, Inc. Pediatrics Past Accepting new patients

Locations

667 Stoneleigh Ave
Ste 111
Carmel, NY 10512
Phone (845) 278-8637

19 Bradhurst Ave
Hawthorne, NY 10532
Phone (914) 493-7235

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: lalaine.mortera.p1@direct.cwpw.nextgenshare.com

Organizations & group practices 3

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374710400000",
    "number": "1275541781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 OLD WATERBURY RD",
            "address_2": "SUITE 204",
            "city": "SOUTHBURY",
            "state": "CT",
            "postal_code": "064883848",
            "telephone_number": "203-262-4250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 OLD WATERBURY RD",
            "address_2": "SUITE 204",
            "city": "SOUTHBURY",
            "state": "CT",
            "postal_code": "064883848",
            "telephone_number": "203-262-4250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORTERA",
        "first_name": "LALAINE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-03",
        "last_updated": "2013-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CT",
            "license": "035458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southbury, CT

Sources for this page

Verify at the official NPI Registry.