Individual provider Active NPI

Thirza C Lareau, M.D.

  • Pediatrics Physician
  • Wilbraham, MA
National Provider Identifier
1275793788
Registry record updated Jul 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
247026 Issued in MA
Practice address
2207 Boston Rd
Wilbraham, MA 01095-1155
Phone
(413) 599-1201
Fax
(413) 596-2940
NPI assigned
Jun 10, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2016

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 247026 MA Primary

Addresses

Primary practice location

2207 Boston Rd
Wilbraham, MA 01095-1155

Mailing address

2207 Boston Rd
Wilbraham, MA 01095-1155
Phone (413) 599-1201

Other identifiers 1

IdentifierTypeStateIssuer
110089281AMedicaidMA

Other names 1

  • Dr. Katherine Thirza Campbell Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20160227000037 MA Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 6800191982

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
George F Vitek MD & Associates PC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: tlareau14109@direct.chppoc.masshiway.net

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.

NPI Registry JSON

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

{
    "created_epoch": "1213056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468368000000",
    "number": "1275793788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2207 BOSTON RD",
            "city": "WILBRAHAM",
            "state": "MA",
            "postal_code": "010951155",
            "telephone_number": "413-599-1201",
            "fax_number": "413-596-2940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2207 BOSTON RD",
            "city": "WILBRAHAM",
            "state": "MA",
            "postal_code": "010951155",
            "telephone_number": "413-599-1201",
            "fax_number": "413-596-2940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAREAU",
        "first_name": "THIRZA",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-10",
        "last_updated": "2016-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "247026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110089281A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHERINE",
            "last_name": "CAMPBELL",
            "middle_name": "THIRZA",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wilbraham, MA

Sources for this page

Verify at the official NPI Registry.