Individual provider Active NPI

Leonard Wayne Stern, MD

  • Psychiatry Physician
  • Waterbury, CT
National Provider Identifier
1457462665
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
021777 Issued in CT
Practice address
88 Grandview Avenue
Waterbury, CT 06708-2509
Phone
(203) 573-6525
Fax
(203) 573-7240
NPI assigned
Aug 31, 2006
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 021777 CT Primary

Addresses

Primary practice location

88 Grandview Avenue
Waterbury, CT 06708-2509

Mailing address

88 Grandview Avenue
Waterbury, CT 06708-2509
Phone (203) 573-6525

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031105000468 CT Practitioner - PsychiatryPractitioner - Geriatric Psychiatry 2567374663 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Geriatric Psychiatry
Education
New York Medical College, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Staywell Health Care Inc.Group PAC ID 6305750480, 43 clinicians

Practice addresses (Care Compare)

1309 S Main St
Waterbury, CT 06706-1758
Phone (203) 756-8021

402 E Main St
Waterbury, CT 06702-1701
Phone (203) 755-1143

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
021777CTMDPsychiatry Physician

Interoperability endpoints

  • Direct secure messaging: lstern@direct.wtbyhosp.org

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, 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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1457462665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "88 GRANDVIEW AVENUE",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067082509",
            "telephone_number": "203-573-6525",
            "fax_number": "203-573-7240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "88 GRANDVIEW AVENUE",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067082509",
            "telephone_number": "203-573-6525",
            "fax_number": "203-573-7240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STERN",
        "first_name": "LEONARD",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "021777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

Verify at the official NPI Registry.