Individual provider Active NPI

Kathleen M Lacson, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Ithaca, NY
National Provider Identifier
1891769907
Registry record updated Feb 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
F401607-1 Issued in NY
Practice address
832 Hanshaw Rd FL 2
Ithaca, NY 14850-1548
Phone
(917) 887-0031
Fax
(607) 793-6149
NPI assigned
Feb 15, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 430739-1 NY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X F401607-1 NY Primary

Addresses

Primary practice location

832 Hanshaw Rd FL 2
Ithaca, NY 14850-1548

Mailing address

832 Hanshaw Rd FL 2
Ithaca, NY 14850-1548
Phone (917) 887-0031

Other practice location 1

600 Roe Ave
Elmira, NY 14905-1629
Phone (607) 737-4248

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040618000264 NY Practitioner - Certified Registered Nurse Anesthetist (Crna) 7719961473 Reassigns benefits to 1 organization
I20220610000420 NY Practitioner - Nurse Practitioner 7719961473 Practice locations: Ithaca, NY

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Associated Anesthesiologists of the Finger Lakes LLPGroup PAC ID 3476597303, 25 clinicians

Practice addresses (Care Compare)

600 Roe Ave
Elmira, NY 14905-1629
Phone (607) 737-4100

832 Hanshaw Rd
FL 2
Ithaca, NY 14850-1548
Phone (607) 592-0448

Hospital & facility affiliations

  • Arnot Ogden Medical Center Hospital, Elmira, NY, CCN 330090

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
430739NYMDAcute Care Nurse Practitioner
F401607-1NYMDPsychiatric/Mental Health Nurse Practitioner
430739-1NYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Anesthesiologists of the Finger Lakes, L.L.P. CurrentSince Jan 1, 2009 Accepting new patients
Greenwich Medical Anesthesia, P.C. Past Accepting new patients
Kathleen Lacson, NP PastSince May 12, 2022 Accepting new patients

Locations

555 Saint Josephs Blvd
Elmira, NY 14901
Phone (607) 733-6541

600 Roe Ave
Elmira, NY 14905
Phone (607) 733-3639

Interoperability endpoints

  • Direct secure messaging: kathleen.lacson.1@33079.direct.athenahealth.com

Organizations & group practices 3

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 1

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": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707696000000",
    "number": "1891769907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "832 HANSHAW RD FL 2",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501548",
            "telephone_number": "917-887-0031",
            "fax_number": "607-793-6149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "832 HANSHAW RD FL 2",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501548",
            "telephone_number": "917-887-0031",
            "fax_number": "607-793-6149"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 Roe Ave",
            "address_purpose": "LOCATION",
            "city": "Elmira",
            "state": "NY",
            "postal_code": "149051629",
            "country_code": "US",
            "telephone_number": "607-737-4248",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LACSON",
        "first_name": "KATHLEEN",
        "middle_name": "M",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-15",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "430739-1",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F401607-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ithaca, NY

Sources for this page

Verify at the official NPI Registry.