Individual provider Active NPI

Laura Lennon, M.D.

  • Cardiovascular Disease Physician
  • Bay Shore, NY
National Provider Identifier
1477593978
Registry record updated Sep 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
200075 Issued in NY
Practice address
1916 Union Blvd
Bay Shore, NY 11706-7921
Phone
(631) 666-2290
Fax
(631) 666-2283
NPI assigned
Jun 7, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 200075 NY Primary

Addresses

Primary practice location

1916 Union Blvd
Bay Shore, NY 11706-7921

Mailing address

1916 Union Blvd
Bay Shore, NY 11706-7921
Phone (631) 666-2290

Other identifiers 1

IdentifierTypeStateIssuer
02263954MedicaidNY

Other names 1

  • Laura Coudrey Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL SMITHTOWN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, MT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040331001223 NY Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Nuclear Medicine 6507858479 Reassigns benefits to 4 organizations
I20260513003015 MT Practitioner - Cardiovascular Disease (Cardiology) 6507858479 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cardiac Ekg Interpretation, P. C.Group PAC ID 2466345103, 57 clinicians
Great Falls Clinic LLCGroup PAC ID 8325944499, 73 clinicians
CMSC LLCGroup PAC ID 5890602494, 92 clinicians
Premiere Cardiology PLLCGroup PAC ID 0446303911, 4 clinicians
CHS Physician Partners PCGroup PAC ID 7618955667, 739 clinicians

Practice addresses (Care Compare)

1000 Montauk Hwy
West Islip, NY 11795-4927
Phone (631) 465-6225

1400 29TH St S
Great Falls, MT 59405-5315
Phone (406) 454-2171

1509 29TH St S
Great Falls, MT 59405-5363
Phone (406) 771-3500

1916 Union Blvd
Bay Shore, NY 11706-7921
Phone 6316662290176

3000 15TH Ave S
Great Falls, MT 59405-5240
Phone (406) 454-2171

3010 15TH Ave S
Great Falls, MT 59405-5240
Phone (406) 216-8000

Hospital & facility affiliations

  • St Catherine of Siena Hospital Hospital, Smithtown, NY, CCN 330401
  • Great Falls Clinic Hospital Hospital, Great Falls, MT, CCN 270086
  • Good Samaritan Hospital Medical Center Hospital, West Islip, NY, CCN 330286
  • Benefis Hospitals Inc Hospital, Great Falls, MT, CCN 270012

Merit-based Incentive Payment System (MIPS)

Final score
24.04 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
80.15

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Premiere Cardiology PLLC Cardiovascular Disease CurrentSince Aug 1, 2009 Accepting new patients
North Shore-Lij Medical PC Cardiovascular Disease CurrentSince Aug 3, 2015 Accepting new patients
North Shore - Lij Medical PC CurrentSince Aug 3, 2015 Accepting new patients
CHS Physician Partners, PC Current Accepting new patients
CHS Physician Partners, P.C Cardiovascular Disease CurrentSince Sep 17, 2025 Accepting new patients
Laura Coudrey, M.D., P.C. Cardiovascular Disease PastSince Jan 1, 1999 Accepting new patients

Locations

301 Montauk Hwy
Bay Shore, NY 11706
Phone (631) 630-3977

1916 Union Blvd
Bay Shore, NY 11706
Phone (631) 666-2290

1554 Northern Blvd
Manhasset, NY 11030
Phone (516) 390-9242

300 Community Dr
Plandome, NY 11030

1000 N Village Ave
Rockville Ctr, NY 11570
Phone (516) 705-1012

100 Port Washington Blvd
Ste G3
Roslyn, NY 11576
Phone (516) 627-4800

50 Route 25A
Smithtown, NY 11787
Phone (631) 465-6225

269 E Main St
Bldg D
Smithtown, NY 11787
Phone (631) 361-2121

307 E Middle Country Rd
Smithtown, NY 11787
Phone (631) 265-4485

1000 Montauk Hwy
West Islip, NY 11795
Phone (516) 705-2689

972 Brush Hollow Rd
Westbury, NY 11590

Networks

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

Interoperability endpoints

  • Direct secure messaging: lauracoudrey@pc.allscriptsdirect.net

Organizations & group practices 9

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 6

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

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726012800000",
    "number": "1477593978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1916 UNION BLVD",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117067921",
            "telephone_number": "631-666-2290",
            "fax_number": "631-666-2283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1916 UNION BLVD",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117067921",
            "telephone_number": "631-666-2290",
            "fax_number": "631-666-2283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LENNON",
        "first_name": "LAURA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-07",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "200075",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02263954",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "SMITHTOWN",
            "affiliation": "N",
            "address_1": "1916 Union Blvd",
            "city": "Bay Shore",
            "state": "NY",
            "country_code": "US",
            "postal_code": "117067921",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "COUDREY",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bay Shore, NY

Sources for this page

Verify at the official NPI Registry.