Individual provider Active NPI

William R Latreille Jr., M.D.

  • Internal Medicine Physician
  • Hogansburg, NY
National Provider Identifier
1508885716
Registry record updated Mar 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
142278 Issued in NY
Practice address
412 State Route 37
Hogansburg, NY 13655
Phone
(518) 358-3141
NPI assigned
Jul 19, 2006
Last updated
Mar 15, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 142278 NY Primary

Addresses

Primary practice location

412 State Route 37
Hogansburg, NY 13655

Mailing address

412 State Route 37
Hogansburg, NY 13655-3109
Phone (518) 358-3141

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20041102001106 NY Practitioner - Internal Medicine 4284696170 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1971
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alice Hyde Medical CenterGroup PAC ID 4082525837, 88 clinicians
St Regis Mohawk TribeGroup PAC ID 5799748547, 11 clinicians

Practice addresses (Care Compare)

183 Park St
Suite 7
Malone, NY 12953-1238
Phone (518) 481-2287

412 State Route 37
Hogansburg, NY 13655-3109
Phone (518) 358-3141

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
142278NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alice Hyde Medical Center Current Accepting new patients
St Regis Mohawk Tribe CurrentSince May 18, 2018 Accepting new patients
Alice Hyde Medical Center Internal Medicine CurrentSince Jun 27, 2011 Accepting new patients
Alice Hyde Medical Center Past Accepting new patients
University of Vermont Medical Group New York PLLC Past Accepting new patients

Locations

6087 State Route 11
Chateaugay, NY 12920
Phone (518) 481-8450

404 State Route 37
Hogansburg, NY 13655
Phone (518) 358-3141

412 State Route 37
Hogansburg, NY 13655
Phone (518) 358-3141

15 4th St
Malone, NY 12953
Phone (518) 481-8160

183 Park St
Ste 7
Malone, NY 12953
Phone (201) 616-2099

969 State Route 11
Moira, NY 12957
Phone (518) 529-7847

Interoperability endpoints

  • Direct secure messaging: williamlatreille@hiemail.healtheconnections.org
  • Direct secure messaging: wlatreille205558@direct.uvmhealth.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 3

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": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331769600000",
    "number": "1508885716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 STATE ROUTE 37",
            "city": "HOGANSBURG",
            "state": "NY",
            "postal_code": "136553109",
            "telephone_number": "518-358-3141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 STATE ROUTE 37",
            "city": "HOGANSBURG",
            "state": "NY",
            "postal_code": "13655",
            "telephone_number": "518-358-3141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATREILLE",
        "first_name": "WILLIAM",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2012-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "142278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hogansburg, NY

Sources for this page

Verify at the official NPI Registry.