Individual provider Active NPI

Laura C Vander Poel, DPM

  • Foot & Ankle Surgery Podiatrist
  • Enfield, CT
National Provider Identifier
1477781383
Registry record updated Jun 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
00887 Issued in CT
Practice address
1379 Enfield Street
Enfield, CT 06082-5524
Phone
(860) 741-3041
NPI assigned
Jun 30, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 00887 CT Primary

Addresses

Primary practice location

1379 Enfield Street
Enfield, CT 06082-5524

Mailing address

1379 Enfield Street
Enfield, CT 06082-5524
Phone (860) 741-3041

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lvanderpoel15904@direct.stfranciscare.org Direct

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120615000321 CT Practitioner - Podiatry 4587828900 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Podiatrycare, PCGroup PAC ID 7719022987, 4 clinicians

Practice addresses (Care Compare)

1379 Enfield St
Enfield, CT 06082-5524
Phone (860) 741-3041

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue89
Removal of nail tissue434
Removal or shaving of skin growth263

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
00887CTMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Podiatrycare, PC Foot & Ankle Surgery CurrentSince Jul 2, 2012 Accepting new patients
Podiatrycare, PC Foot & Ankle Surgery CurrentSince Jul 2, 2012 Accepting new patients

Locations

1379 Enfield St
Enfield, CT 06082
Phone (860) 698-2981

1350 Sullivan Ave
South Windsor, CT 06074
Phone (860) 644-6525

Interoperability endpoints

  • Direct secure messaging: lvanderpoel@ctfoot.directglo.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 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": "1246320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624406400000",
    "number": "1477781383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1379 ENFIELD STREET",
            "city": "ENFIELD",
            "state": "CT",
            "postal_code": "060825524",
            "telephone_number": "860-741-3041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1379 ENFIELD STREET",
            "city": "ENFIELD",
            "state": "CT",
            "postal_code": "060825524",
            "telephone_number": "860-741-3041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDER POEL",
        "first_name": "LAURA",
        "middle_name": "C",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-30",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CT",
            "license": "00887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lvanderpoel15904@direct.stfranciscare.org",
            "affiliation": "N",
            "endpointDescription": "Trinity Health of New England",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1379 ENFIELD STREET",
            "city": "ENFIELD",
            "state": "CT",
            "country_code": "US",
            "postal_code": "06082",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Enfield, CT

Sources for this page

Verify at the official NPI Registry.