Individual provider Active NPI

Elliot Lach, M.D.

  • Plastic and Reconstructive Surgery Physician
  • Southborough, MA
National Provider Identifier
1508876715
Registry record updated Oct 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
53160 Issued in MA
Practice address
77 Turnpike Rd
Southborough, MA 01772-2110
Phone
(508) 481-0300
NPI assigned
Aug 9, 2006
Last updated
Oct 11, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery Physician 2086S0122X 53160 MA Primary

Addresses

Primary practice location

77 Turnpike Rd
Southborough, MA 01772-2110

Mailing address

77 Turnpike Rd Ste 101
Southborough, MA 01772-2110
Phone (508) 480-8883

Other identifiers 1

IdentifierTypeStateIssuer
9735071MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20040923000675 MA Practitioner - Plastic and Reconstructive SurgeryPractitioner - Hand Surgery 3577531805 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive SurgeryAlso: Hand Surgery
Education
Yale University School of Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

77 Turnpike Rd
Southborough, MA 01772-2110
Phone (508) 480-8883

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
53160MAMDPlastic and Reconstructive Surgery Physician

Organizations & group practices 1

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 1

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": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570752000000",
    "number": "1508876715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 TURNPIKE RD STE 101",
            "city": "SOUTHBOROUGH",
            "state": "MA",
            "postal_code": "017722110",
            "telephone_number": "508-480-8883",
            "fax_number": "617-752-3690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 TURNPIKE RD",
            "city": "SOUTHBOROUGH",
            "state": "MA",
            "postal_code": "017722110",
            "telephone_number": "508-481-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACH",
        "first_name": "ELLIOT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2019-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "MA",
            "license": "53160",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9735071",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southborough, MA

Sources for this page

Verify at the official NPI Registry.