Individual provider Active NPI

Janese Shade' Laster, M.D.

  • Gastroenterology Physician
  • Bangor, ME
National Provider Identifier
1679839047
Registry record updated Oct 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
MD23165 Issued in ME
Practice address
417 State St Ste 121
Bangor, ME 04401-6630
Phone
(207) 973-4266
NPI assigned
Apr 10, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 296806 NY
Gastroenterology Physician 207RG0100X MD23165 ME Primary

Addresses

Primary practice location

417 State St Ste 121
Bangor, ME 04401-6630

Mailing address

43 Whiting Hill Rd Ste 300
Brewer, ME 04412-1006

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address janeselaster@sium.allscriptsdirect.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MD2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20180817002494 IL Practitioner - GastroenterologyPractitioner - Internal Medicine 4486903895 Reassigns benefits to 2 organizations
I20231031002932 MD Practitioner - GastroenterologyPractitioner - Internal Medicine 4486903895 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
University of Texas Medical Branch at Galveston, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kaiser Foundation Health Plan of the Mid Atlantic States, IncGroup PAC ID 3779495858, shared by 17 NPIs, 1,921 clinicians

Practice addresses (Care Compare)

1701 Twin Springs Rd
Halethorpe, MD 21227-3553
Phone (410) 737-5000

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD23165MEMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Sep 17, 2023 Accepting new patients
Siu Physicians & Surgeons, Inc CurrentSince Sep 21, 2018 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc Gastroenterology Current Accepting new patients
Siu Physicians & Surgeons, Inc Gastroenterology CurrentSince Sep 21, 2018 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Sep 17, 2023 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Sep 17, 2023 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Sep 17, 2023 Accepting new patients
Rockford Health Physicians CurrentSince Sep 1, 2018 Accepting new patients

Locations

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

2300 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-5510

2400 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-6310

751 N Rutledge St
Springfield, IL 62702
Phone (217) 545-0182

751 N Rutledge St
Ste 2300
Springfield, IL 62702
Phone (217) 545-3821

7070 Samuel Morse Dr
Columbia, MD 21046
Phone (410) 309-4600

7190 Crestwood Blvd
Frederick, MD 21703
Phone (240) 529-1700

1701 Twin Springs Rd
Halethorpe, MD 21227
Phone (410) 737-5000

2101 E Jefferson St
Ste 4EPFS
Rockville, MD 20852

2101 E Jefferson St
#4E
Rockville, MD 20852

2101 E Jefferson St
Ste 6WPPQA
Rockville, MD 20852
Phone (301) 816-5853

2391 Greenspring Dr
Timonium, MD 21093
Phone (410) 847-3000

6701 N Charles St
Towson, MD 21204
Phone (443) 849-2000

Interoperability endpoints

  • Direct secure messaging: janese.laster.1@26520.direct.athenahealth.com

Organizations & group practices 8

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": "1334016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603324800000",
    "number": "1679839047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 WHITING HILL RD STE 300",
            "city": "BREWER",
            "state": "ME",
            "postal_code": "044121006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 STATE ST STE 121",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044016630",
            "telephone_number": "207-973-4266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LASTER",
        "first_name": "JANESE",
        "middle_name": "SHADE'",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-10",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "296806",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "ME",
            "license": "MD23165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "janeselaster@sium.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "751 N Rutledge St Ste 2300",
            "city": "Springfield",
            "state": "IL",
            "country_code": "US",
            "postal_code": "627024968",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bangor, ME

Sources for this page

Verify at the official NPI Registry.