Individual provider Active NPI

Laura Sundstrom, CNM

  • Advanced Practice Midwife
  • New Haven, CT
National Provider Identifier
1720056963
Registry record updated Feb 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
000279 Issued in CT
Practice address
374 Grand Ave
Fair Haven Community Health Center
New Haven, CT 06513
Phone
(203) 777-7411
NPI assigned
Mar 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 000279 CT Primary

Addresses

Primary practice location

374 Grand Ave
Fair Haven Community Health Center
New Haven, CT 06513

Mailing address

374 Grand Ave
New Haven, CT 06513-3733
Phone (203) 777-7411

Other identifiers 1

IdentifierTypeStateIssuer
004235900MedicaidCT

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050823000065 CT Practitioner - Certified Nurse Midwife (CNM) 8022049808 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yale UniversityGroup PAC ID 9436061736, 2,632 clinicians

Practice addresses (Care Compare)

20 York St
New Haven, CT 06510-3220
Phone (203) 688-4242

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
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
000279CTMDNaturopath

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University CurrentSince Jan 1, 2023 Accepting new patients
Yale University CurrentSince Jan 1, 2023 Accepting new patients

Locations

50 Division St
New Haven, CT 06511
Phone (203) 785-2140

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

428 Columbus Ave
New Haven, CT 06519
Phone (203) 503-3228

1354 Chapel St
New Haven, CT 06511
Phone (203) 867-8300

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

Interoperability endpoints

  • Direct secure messaging: lsundstrom42737@direct.ynhh.org

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234310400000",
    "number": "1720056963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "374 GRAND AVE",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065133733",
            "telephone_number": "203-777-7411",
            "fax_number": "203-777-5910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "374 GRAND AVE",
            "address_2": "FAIR HAVEN COMMUNITY HEALTH CENTER",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "06513",
            "telephone_number": "203-777-7411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUNDSTROM",
        "first_name": "LAURA",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-14",
        "last_updated": "2009-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "CT",
            "license": "000279",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004235900",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.