Individual provider Active NPI

Lauren Lacivita, D.O.

  • Emergency Medicine Physician
  • Wilton, CT
National Provider Identifier
1558620807
Registry record updated Dec 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
55839 Issued in CT
Practice address
30 Danbury Rd
Wilton, CT 06897-4457
Phone
(203) 563-3500
NPI assigned
May 8, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 5101019742 MI
Emergency Medicine Physician 207P00000X 282994 NY
Emergency Medicine Physician 207P00000X 55839 CT Primary

Addresses

Primary practice location

30 Danbury Rd
Wilton, CT 06897-4457

Mailing address

1290 Silas Deane Highway
HHC - Cvo
Wethersfield, CT 06109-4337

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CT, FL3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20160930001378 NY Practitioner - Emergency Medicine 4385931583 Reassigns benefits to 3 organizations
I20161125000024 CT Practitioner - Emergency Medicine 4385931583 Reassigns benefits to 3 organizations
I20220617000423 FL Practitioner - Emergency Medicine 4385931583 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Michigan State University College of Osteopathic Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. Vincents Urgent Care LLCGroup PAC ID 6901119767, 43 clinicians
Malina Medical Services PCGroup PAC ID 3779943600, 33 clinicians

Practice addresses (Care Compare)

677 Connecticut Ave
Norwalk, CT 06854-1645
Phone (475) 210-3350

7365 Main St
Suite 7
Stratford, CT 06614-1300
Phone (203) 696-3505

77 Quaker Ridge Rd
Suite 212
New Rochelle, NY 10804-2821
Phone (201) 483-3760

Merit-based Incentive Payment System (MIPS)

Final score
86.33 of 100Reported as group
Quality
82.1
Promoting interoperability
100
Improvement activities
40
Cost
72.34

Merit-based Incentive Payment System (MIPS)

Final score
95.6 of 100Reported as group
Quality
89.17
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
88.05 of 100Reported as group
Quality
83.45
Promoting interoperability
100
Improvement activities
40
Cost
76.72

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101019742MIMDEmergency Medicine Physician
282994NYMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
John T. Mather Memorial Hospital CurrentSince Aug 1, 2016 Accepting new patients
Tampa Bay Emergency Physicians-Heartland LLC Emergency Medicine CurrentSince Jun 13, 2022 Accepting new patients
North Shore-Lij Medical PC Emergency Medicine CurrentSince Nov 28, 2016 Accepting new patients
St. Vincents Urgent Care LLC CurrentSince Sep 15, 2024 Accepting new patients
Malina Medical Services PC Emergency Medicine CurrentSince Apr 7, 2025 Accepting new patients
St. Vincents Urgent Care LLC CurrentSince Sep 15, 2024 Accepting new patients
John T. Mather Memorial Hospital Current Accepting new patients
John T. Mather Memorial Hospital Emergency Medicine CurrentSince Aug 1, 2016 Accepting new patients

Locations

1 Hospital Plz
Stamford, CT 06902
Phone (203) 276-4925

7365 Main St
Ste 7
Stratford, CT 06614
Phone (203) 696-3505

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

30 Danbury Rd
Wilton, CT 06897
Phone (203) 665-9729

4200 Sun N Lake Blvd
Sebring, FL 33872
Phone (863) 314-4406

735 S 5th Ave
Wauchula, FL 33873
Phone (863) 402-3402

301 Montauk Hwy
Bay Shore, NY 11706
Phone (631) 630-3977

327 Beach 19th St
Far Rockaway, NY 11691
Phone (718) 689-7640

77 Quaker Ridge Rd
Ste 212
New Rochelle, NY 10804
Phone (201) 483-3760

7 W 96th St
Apt 1H
New York, NY 10025
Phone (201) 483-3760

300 Community Dr
Plandome, NY 11030

75 N Country Rd
Prt Jefferson, NY 11777
Phone (631) 463-1320

972 Brush Hollow Rd
Westbury, NY 11590

Interoperability endpoints

  • Direct secure messaging: lauren.sokolik@xdr.hhchealthdirect.org

Organizations & group practices 10

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": "1336435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734393600000",
    "number": "1558620807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1290 SILAS DEANE HIGHWAY",
            "address_2": "HHC - CVO",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061094337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 DANBURY RD",
            "city": "WILTON",
            "state": "CT",
            "postal_code": "068974457",
            "telephone_number": "203-563-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACIVITA",
        "first_name": "LAUREN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-08",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5101019742",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "282994",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CT",
            "license": "55839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilton, CT

Sources for this page

Verify at the official NPI Registry.