NPIMap

Individual provider Active NPI

Michael Allen Lettrick, MD

  • Family Medicine Physician
  • Castleton, NY
National Provider Identifier
1447232855
Registry record updated Jun 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
189372 Issued in NY
Practice address
1528 Columbia Tpke
Castleton, NY 12033-9584
Phone
(518) 477-1191
Fax
(518) 477-1255
NPI assigned
Nov 19, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 189372 NY Primary

Addresses

Primary practice location

1528 Columbia Tpke
Castleton, NY 12033-9584

Mailing address

3 Blue Mountain TRL
East Greenbush, NY 12061-2401
Phone (518) 477-1191

Other identifiers 1

IdentifierTypeStateIssuer
01699403MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110302000764 NY Practitioner - Family Practice 1759562424 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Albany Medical College of Union University, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lettrick Family Medicine PLLCGroup PAC ID 5294993044, 2 clinicians

Practice addresses (Care Compare)

2500 Pond VW
Suite 103
Castleton on Hudson, NY 12033-9775
Phone (518) 477-1191

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Michael a. Lettrick MD PC Family Medicine CurrentSince Jun 19, 2000 Accepting new patients

Locations

1528 Columbia Tpke
Castleton on Hudson, NY 12033
Phone (518) 477-1191

Interoperability endpoints

  • Direct secure messaging: mlettrick@lettrickfamilymedicine.ssdirect.aprima.com

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.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1132358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276732800000",
    "number": "1447232855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 BLUE MOUNTAIN TRL",
            "city": "EAST GREENBUSH",
            "state": "NY",
            "postal_code": "120612401",
            "telephone_number": "518-477-1191",
            "fax_number": "518-477-1255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1528 COLUMBIA TPKE",
            "city": "CASTLETON",
            "state": "NY",
            "postal_code": "120339584",
            "telephone_number": "518-477-1191",
            "fax_number": "518-477-1255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LETTRICK",
        "first_name": "MICHAEL",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-19",
        "last_updated": "2010-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "189372",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01699403",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Castleton, NY

Sources for this page

Verify at the official NPI Registry.