Individual provider Active NPI

Michael Lewis Laccheo, MD

  • Internal Medicine Physician
  • Williamsburg, VA
National Provider Identifier
1508087677
Registry record updated Feb 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101253794 Issued in VA
Practice address
263 McLaws Cir Ste 105
Williamsburg, VA 23185-5674
Phone
(757) 941-5600
NPI assigned
May 2, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 0101253794 VA
Internal Medicine Physician 207R00000X 0101253794 VA Primary

Addresses

Primary practice location

263 McLaws Cir Ste 105
Williamsburg, VA 23185-5674

Mailing address

263 McLaws Cir Ste 105
Williamsburg, VA 23185-5674
Phone (757) 941-5600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20130815000336 VA Practitioner - RheumatologyPractitioner - Internal Medicine 5496933012 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101253794VAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vpa PC Internal Medicine CurrentSince Nov 9, 2015 Accepting new patients
Vpa PC Internal Medicine CurrentSince Nov 9, 2015 Accepting new patients

Locations

263 McLaws Cir
Ste 105
Williamsburg, VA 23185
Phone (757) 645-0831

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.

NPI Registry JSON

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582848000000",
    "number": "1508087677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "263 MCLAWS CIR STE 105",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231855674",
            "telephone_number": "757-941-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "263 MCLAWS CIR STE 105",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231855674",
            "telephone_number": "757-941-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACCHEO",
        "first_name": "MICHAEL",
        "middle_name": "LEWIS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-02",
        "last_updated": "2020-02-28",
        "certification_date": "2020-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "VA",
            "license": "0101253794",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101253794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsburg, VA

Sources for this page

Verify at the official NPI Registry.