Individual provider Active NPI

Pierre H Lataillade, MD

  • Pulmonary Disease Physician
  • Gloversville, NY
National Provider Identifier
1801972120
Registry record updated Jan 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
152599 Issued in NY
Practice address
99 E State St
Mab-GPCC
Gloversville, NY 12078-1203
Phone
(518) 775-4333
Fax
(518) 773-5620
NPI assigned
Oct 29, 2006
Last updated
Jan 21, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 152599 NY Primary

Addresses

Primary practice location

99 E State St
Mab-GPCC
Gloversville, NY 12078-1203

Mailing address

99 E State St
PO Box 1250
Gloversville, NY 12078-1203
Phone (518) 775-4333

Other identifiers 1

IdentifierTypeStateIssuer
00933459MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20101111001571 NY Practitioner - Pulmonary DiseasePractitioner - Internal Medicine 3274728563 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Internal Medicine
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nysarc Inc Fulton County ChapterGroup PAC ID 5890717979, 27 clinicians

Practice addresses (Care Compare)

465 N Perry St
Johnstown, NY 12095-1014
Phone (518) 736-3937

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
152599NYMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nysarc Inc Fulton County Chapter CurrentSince May 1, 2012 Accepting new patients
Nathan Littauer Hospital Association Past Accepting new patients

Locations

127 E State St
Gloversville, NY 12078
Phone (518) 773-7931

465 N Perry St
Johnstown, NY 12095
Phone (518) 736-3937

Interoperability endpoints

  • Direct secure messaging: latailp@lexclinic.medentdirect.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1162080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421798400000",
    "number": "1801972120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 E STATE ST",
            "address_2": "PO BOX 1250",
            "city": "GLOVERSVILLE",
            "state": "NY",
            "postal_code": "120781203",
            "telephone_number": "518-775-4333",
            "fax_number": "518-773-5620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 E STATE ST",
            "address_2": "MAB-GPCC",
            "city": "GLOVERSVILLE",
            "state": "NY",
            "postal_code": "120781203",
            "telephone_number": "518-775-4333",
            "fax_number": "518-773-5620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATAILLADE",
        "first_name": "PIERRE",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-29",
        "last_updated": "2015-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NY",
            "license": "152599",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00933459",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gloversville, NY

Sources for this page

Verify at the official NPI Registry.