NPIMap

Individual provider Active NPI

Stephen C. Lattanzi, M.D.

  • Hematology & Oncology Physician
  • Mountain Home, AR
National Provider Identifier
1801894555
Registry record updated Dec 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
E-9749 Issued in AR
Practice address
628 Hospital Dr
Ground Floor, Suite a
Mountain Home, AR 72653-2953
Phone
(870) 425-4402
Fax
(860) 437-2236
NPI assigned
Jul 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2016

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 035831 CT
Hematology & Oncology Physician 207RH0003X E-9749 AR Primary
Internal Medicine Physician 207R00000X 035831 CT
Medical Oncology Physician 207RX0202X 035831 CT

Addresses

Primary practice location

628 Hospital Dr
Ground Floor, Suite a
Mountain Home, AR 72653-2953

Mailing address

PO Box 2038
Mountain Home, AR 72654-2038
Phone (870) 424-7070

Other identifiers 1

IdentifierTypeStateIssuer
001358317MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060221000501 CT Practitioner - Hematology/OncologyPractitioner - Internal Medicine 5496748147 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/OncologyAlso: Internal Medicine
Education
University of Connecticut School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northeast Medical Group IncGroup PAC ID 1254233836, 1,357 clinicians

Practice addresses (Care Compare)

230 Waterford Pkwy S
Waterford, CT 06385-1219
Phone (860) 444-3744

Hospital & facility affiliations

  • Yale New Haven Health - Health at Home Southeast Home health agency, Waterford, CT, CCN 077015
  • Masonicare Home Health and Hospice Inc Hospice, Wallingford, CT, CCN 071516
  • Hartford Healthcare at Home Hospice, East Hartford, CT, CCN 071507
  • Home Care Plus, Inc Hospice, Guilford, CT, CCN 071544
  • Lawrence & Memorial Hospital Hospital, New London, CT, CCN 070007
  • Westerly Hospital Hospital, Westerly, RI, CCN 410013
  • Yale-New Haven Hospital Hospital, New Haven, CT, CCN 070022

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
86.54
Promoting interoperability
99.98
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Medical Group, Inc. Internal Medicine CurrentSince Mar 4, 2019 Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

95 Armory Rd
Stratford, CT 06614
Phone (203) 384-3388

230 Waterford Parkway S
Waterford, CT 06385
Phone (860) 271-4360

Interoperability endpoints

  • Direct secure messaging: slattanzi329880@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 8

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": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481760000000",
    "number": "1801894555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2038",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726542038",
            "telephone_number": "870-424-7070",
            "fax_number": "870-424-6616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "628 HOSPITAL DR",
            "address_2": "GROUND FLOOR, SUITE A",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726532953",
            "telephone_number": "870-425-4402",
            "fax_number": "860-437-2236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATTANZI",
        "first_name": "STEPHEN",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2016-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "CT",
            "license": "035831",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "AR",
            "license": "E-9749",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "035831",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "CT",
            "license": "035831",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001358317",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain Home, AR

Sources for this page

Verify at the official NPI Registry.