Bruce V Lattyak, M.D.

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

A62583 Issued in CA

Practice address

300 Sierra College Dr Ste 240
Grass Valley, CA 95945-5086

Phone

(530) 273-3400

Fax

(530) 274-3400

NPI assigned

May 13, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Plastic and Reconstructive SurgeryAlso: Otolaryngology

Education

University of California, San Francisco School of Medicine, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bruce V Lattyak MD IncGroup PAC ID 2466514245, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sierra Nevada Memorial Hospital Hospital, Grass Valley, CA, CCN 050150

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/AFDHCA
• Direct secure messaging: bruce.lattyak@bvli.eclinicaldirectplus.com

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.

• Bruce V Lattyak M.D., Inc.

  • Plastic Surgery Physician
  • Grass Valley, CA
  • NPI 1275707424
  Medicare reassignment Care Compare group NPD Authorized official
• Grass Valley Outpatient Surgery Center LP

  • Ambulatory Surgical Clinic/Center
  • Grass Valley, CA
  • NPI 1184937468
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Sierra Nevada Memorial-Miners Hospital

  • General Acute Care Hospital
  • Grass Valley, CA
  • NPI 1659361392
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1210636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567036800000",
    "number": "1629245238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 SIERRA COLLEGE DR STE 240",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959455086",
            "telephone_number": "530-273-3400",
            "fax_number": "530-274-3400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 SIERRA COLLEGE DR STE 240",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959455086",
            "telephone_number": "530-273-3400",
            "fax_number": "530-274-3400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "280 Sierra College Drive",
            "address_2": "Suite 105",
            "address_purpose": "LOCATION",
            "city": "Grass Valley",
            "state": "CA",
            "postal_code": "95945",
            "country_code": "US",
            "telephone_number": "530-273-3400",
            "fax_number": "530-274-3400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LATTYAK",
        "first_name": "BRUCE",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-13",
        "last_updated": "2019-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "CA",
            "license": "A62583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Laplante
• Kari Larsen
• Lora Larsen, CADC-II, LAADC
• Zachary Taylor Larsen
• Bryan Lassegard
• Laura Wilcox
• Sam Lautzenhiser, BA
• Bonnie Lawrence, RRW
• Kristin M Lawrence, LPT
• Jonathan Robert Lawson, RN, BSN, CNOR

• Plastic Surgery Physician in Grass Valley, CA
• Providers in Grass Valley, CA by specialty
• Plastic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.