NPIMap

Individual provider Active NPI

Laurence I. Radin, MD

  • Neurology Physician
  • New London, CT
National Provider Identifier
1508860156
Registry record updated Sep 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
032051 Issued in CT
Practice address
350 Montauk Ave
New London, CT 06320-4730
Phone
(860) 443-1891
Fax
(860) 443-2980
NPI assigned
Jun 10, 2005
Last updated
Sep 25, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 032051 CT Primary

Addresses

Primary practice location

350 Montauk Ave
New London, CT 06320-4730

Mailing address

350 Montauk Ave
New London, CT 06320-4730
Phone (860) 443-1891

Other identifiers 1

IdentifierTypeStateIssuer
1320514MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100224000354 CT Practitioner - Neurology 0143208991 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
University of Connecticut School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hartford Healthcare Medical Group Specialists PLLCGroup PAC ID 3173866241, 1,555 clinicians

Practice addresses (Care Compare)

196 Pkwy S
Suite 201
Waterford, CT 06385
Phone (860) 425-5319

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.42 of 100Reported as group
Quality
83.36
Promoting interoperability
100
Improvement activities
40
Cost
75.9

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
032051CTMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Healthcare Medical Group Specialists, PLLC Neurology CurrentSince Nov 1, 2023 Accepting new patients
Hartford Healthcare Medical Group Specialists LLC CurrentSince Nov 1, 2023 Accepting new patients
Neurological Group, PC Past Accepting new patients
Neurological Group, PC Past Accepting new patients

Locations

365 Montauk Ave
New London, CT 06320
Phone (860) 271-4364

1244 Storrs Rd
Storrs Mansfield, CT 06268
Phone (860) 724-2579

196 Parkway S
Ste 201
Waterford, CT 06385
Phone (860) 440-0688

5 Dayton Rd
Ste 201
Waterford, CT 06385

1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977

Interoperability endpoints

  • Direct secure messaging: laurence.radin@xdr.hhchealthdirect.org

Organizations & group practices 5

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.

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": "1118361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190678400000",
    "number": "1508860156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 MONTAUK AVE",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063204730",
            "telephone_number": "860-443-1891",
            "fax_number": "860-443-2980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 MONTAUK AVE",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063204730",
            "telephone_number": "860-443-1891",
            "fax_number": "860-443-2980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADIN",
        "first_name": "LAURENCE",
        "middle_name": "I.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-10",
        "last_updated": "2007-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CT",
            "license": "032051",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1320514",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New London, CT

Sources for this page

Verify at the official NPI Registry.