Individual provider Active NPI

Latiaha Nichelle Lewis, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • East Hartford, CT
National Provider Identifier
1891411641
Registry record updated Oct 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
11062 Issued in CT
Practice address
Intercommunity, Inc
281 Main Street
East Hartford, CT 06118
Phone
(860) 569-5900
NPI assigned
Oct 13, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 11062 CT Primary

Addresses

Primary practice location

Intercommunity, Inc
281 Main Street
East Hartford, CT 06118

Mailing address

86 Summer Hill Rd
Middletown, CT 06457-5646
Phone (860) 710-3104

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230309000224 CT Practitioner - Nurse Practitioner 8325411580 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Step Up Care PC LLCGroup PAC ID 5496088346, 176 clinicians

Practice addresses (Care Compare)

111 Westcott Rd
Danielson, CT 06239-2929
Phone (718) 298-4375

Merit-based Incentive Payment System (MIPS)

Final score
87.14 of 100Reported as group
Quality
71.85
Improvement activities
40
Cost
75.41

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11062CTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Step Up Care PC LLC CurrentSince Oct 1, 2024 Accepting new patients
Intercommunity, Inc. CurrentSince Dec 6, 2022 Accepting new patients
Impact Health Psych PC Psychiatric/Mental Health CurrentSince Feb 1, 2025 Accepting new patients
Intercommunity, Inc. CurrentSince Dec 6, 2022 Accepting new patients

Locations

111 Westcott Rd
Danielson, CT 06239
Phone (860) 774-9540

281 Main St
East Hartford, CT 06118
Phone (860) 291-1335

800 Connecticut Blvd
Fl 4
Hartford, CT 06108
Phone (860) 622-5451

14 Westport Ave
Norwalk, CT 06851
Phone (203) 497-3867

240 Indian River Rd
Ste C
Orange, CT 06477
Phone (203) 497-3867

240 Indian River Rd
Ste C7
Orange, CT 06477
Phone (203) 497-3867

27 Randolph Rd
Howell, NJ 07731
Phone (972) 677-7951

Organizations & group practices 4

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": "1665619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665619200000",
    "number": "1891411641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "86 SUMMER HILL RD",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064575646",
            "telephone_number": "860-710-3104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "INTERCOMMUNITY, INC",
            "address_2": "281 MAIN STREET",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "06118",
            "telephone_number": "860-569-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "LATIAHA",
        "middle_name": "NICHELLE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-13",
        "last_updated": "2022-10-13",
        "certification_date": "2022-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "11062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Hartford, CT

Sources for this page

Verify at the official NPI Registry.