Individual provider Active NPI

Laleh Ardeshirpour, M.D.

  • Pediatric Endocrinology Physician
  • Farmington, CT
National Provider Identifier
1508021809
Registry record updated Apr 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X
License
043051 Issued in CT
Practice address
505 Farmington Ave
Farmington, CT 06032-1901
Phone
(860) 837-6700
Fax
(860) 837-6765
NPI assigned
Jul 25, 2008
Last updated
Apr 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Endocrinology Physician 2080P0205X 043051 CT Primary

Addresses

Primary practice location

505 Farmington Ave
Farmington, CT 06032-1901

Mailing address

60 Old Quarry Rd
Woodbridge, CT 06525-1006
Phone (203) 506-1514

Other identifiers 1

IdentifierTypeStateIssuer
8002773MedicaidCT

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lardeshirpour51293@connecticutchildrens.direct-ci.com

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
I20090113000091 CT Practitioner - Pediatric MedicinePractitioner - Endocrinology 8628131976 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Connecticut Children's Specialty Group, Inc. Pediatric Endocrinology CurrentSince Nov 24, 2021 Accepting new patients
Connecticut Children's Specialty Group, Inc. Pediatric Endocrinology CurrentSince Nov 24, 2021 Accepting new patients

Locations

505 Farmington Ave
Farmington, CT 06032
Phone (860) 837-6700

10 Columbus Blvd
Hartford, CT 06106
Phone (860) 837-5619

10 Columbus Blvd
Fl 4
Hartford, CT 06106
Phone (860) 837-5560

282 Washington St
Hartford, CT 06106
Phone (860) 545-8950

Interoperability endpoints

  • Direct secure messaging: laleh.ardeshirpour.1@7895.direct.athenahealth.com
  • Direct secure messaging: lardeshirpour51293@connecticutchildrens.direct-ci.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, 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": "1216944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714435200000",
    "number": "1508021809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 OLD QUARRY RD",
            "city": "WOODBRIDGE",
            "state": "CT",
            "postal_code": "065251006",
            "telephone_number": "203-506-1514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 FARMINGTON AVE",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060321901",
            "telephone_number": "860-837-6700",
            "fax_number": "860-837-6765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARDESHIRPOUR",
        "first_name": "LALEH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-25",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "CT",
            "license": "043051",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8002773",
            "state": "CT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lardeshirpour51293@connecticutchildrens.direct-ci.com",
            "affiliation": "N",
            "address_1": "505 Farmington Ave",
            "city": "Farmington",
            "state": "CT",
            "country_code": "US",
            "postal_code": "060321901",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Farmington, CT

Sources for this page

Verify at the official NPI Registry.