Individual provider Active NPI

Igor Latich, MD

  • Vascular & Interventional Radiology Physician
  • New Haven, CT
National Provider Identifier
1619154895
Registry record updated Jun 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
051089 Issued in CT
Practice address
20 York Street, T-209
Yale-New Haven Hospital
New Haven, CT 06510
Phone
(203) 688-2259
Fax
(203) 688-5599
NPI assigned
Jan 30, 2008
Last updated
Jun 17, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X 051089 CT Primary

Addresses

Primary practice location

20 York Street, T-209
Yale-New Haven Hospital
New Haven, CT 06510

Mailing address

111 Ardmore Rd
West Hartford, CT 06119-1203

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20121002000411 CT Practitioner - Interventional RadiologyPractitioner - Diagnostic Radiology 8123277449 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional RadiologyAlso: Diagnostic Radiology
Education
Yale University School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rehabilitation Associates IncGroup PAC ID 8022905322, shared by 2 NPIs, 525 clinicians
Yale UniversityGroup PAC ID 9436061736, 2,632 clinicians

Practice addresses (Care Compare)

1931 Black Rock Tpke
Fairfield, CT 06825-3506
Phone (203) 384-8681

20 York St
New Haven, CT 06510-3220
Phone (203) 785-4638

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.36 of 100Reported as group
Quality
77.36
Promoting interoperability
100
Improvement activities
40
Cost
74.27

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
051089CTMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University CurrentSince Aug 1, 2012 Accepting new patients
Yale University Current Accepting new patients
Yale University CurrentSince Aug 1, 2012 Accepting new patients

Locations

300 George St
Fl 6
New Haven, CT 06511
Phone (203) 785-6610

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

20 York St
North Haven, CT 06510
Phone (203) 688-2433

Interoperability endpoints

  • Direct secure messaging: ilatich3728@direct.ynhh.org

Organizations & group practices 3

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 5

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": "1201651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371427200000",
    "number": "1619154895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 ARDMORE RD",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061191203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 YORK STREET, T-209",
            "address_2": "YALE-NEW HAVEN HOSPITAL",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "06510",
            "telephone_number": "203-688-2259",
            "fax_number": "203-688-5599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATICH",
        "first_name": "IGOR",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-01-30",
        "last_updated": "2013-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "CT",
            "license": "051089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.