Individual provider Active NPI

Jeffrey Lagasse, PHARM D

  • Pharmacist
  • Enfield, CT
National Provider Identifier
1376883413
Registry record updated Apr 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PCT0011999 Issued in CT
Practice address
31 Moody Rd
Enfield, CT 06082-3101
Phone
(860) 763-7020
Fax
(860) 763-7022
NPI assigned
Feb 27, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2019

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

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 21990 MD
Pharmacist 183500000X 0202211988 VA
Pharmacist 183500000X RPH-0013511 OR
Pharmacist 183500000X 14388 NE
Pharmacist 183500000X PST020531 LA
Pharmacist 183500000X S020593 AZ
Pharmacist 183500000X PH233629 MA
Pharmacist 183500000X 0000038403 TN
Pharmacist 183500000X 59721 TX
Pharmacist 183500000X 5302043440 MI
Pharmacist 183500000X 018421 KY
Pharmacist 183500000X R2515 NH
Pharmacist 183500000X 061955 NY
Pharmacist 183500000X RP0009365 WV
Pharmacist 183500000X PCT0011999 CT Primary

Addresses

Primary practice location

31 Moody Rd
Enfield, CT 06082-3101

Mailing address

441 Maple Rd
Longmeadow, MA 01106-3119
Phone (413) 519-5080

Other names 1

  • Jeffrey Lagasse Professional name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jeff@mylyfe.health Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
21990MDMDClinical Social Worker
S020593AZMDPharmacist
PCT0011999CTMDPharmacist
018421KYMDPharmacist
PST020531LAMDPharmacist
PH233629MAMDPharmacist
5302043440MIMDPharmacist
14388NEMDPharmacist
R2515NHMDPharmacist
061955NYMDPharmacist
RPH-0013511ORMDPharmacist
0000038403TNMDPharmacist
59721TXMDPharmacist
0202211988VAMDPharmacist
RP0009365WVMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Mylyfe LLC Current Accepting new patients
Mylyfe LLC CurrentSince Jan 31, 2021 Accepting new patients

Locations

31 Moody Rd
Enfield, CT 06082
Phone (844) 469-5933

Organizations & group practices 2

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": "1361923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554163200000",
    "number": "1376883413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "441 MAPLE RD",
            "city": "LONGMEADOW",
            "state": "MA",
            "postal_code": "011063119",
            "telephone_number": "413-519-5080",
            "fax_number": "413-519-5080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 MOODY RD",
            "city": "ENFIELD",
            "state": "CT",
            "postal_code": "060823101",
            "telephone_number": "860-763-7020",
            "fax_number": "860-763-7022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAGASSE",
        "first_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "PHARM D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-02-27",
        "last_updated": "2019-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MD",
            "license": "21990",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "VA",
            "license": "0202211988",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OR",
            "license": "RPH-0013511",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NE",
            "license": "14388",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "LA",
            "license": "PST020531",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S020593",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MA",
            "license": "PH233629",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TN",
            "license": "0000038403",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "59721",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302043440",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KY",
            "license": "018421",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NH",
            "license": "R2515",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "061955",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WV",
            "license": "RP0009365",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CT",
            "license": "PCT0011999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jeff@mylyfe.health",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "441 Maple Rd",
            "city": "Longmeadow",
            "state": "MA",
            "country_code": "US",
            "postal_code": "011063119",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JEFFREY",
            "last_name": "LAGASSE",
            "credential": "PHARM D",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Enfield, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.