Individual provider Active NPI

Lauryn Elizabeth Tetreault, PA

  • Medical Physician Assistant
  • New Haven, CT
National Provider Identifier
1932830585
Registry record updated Jun 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
6021 Issued in CT
Practice address
20 York St
New Haven, CT 06510-3220
Phone
(203) 688-4242
NPI assigned
Jun 23, 2022
Last updated
Jun 14, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 6021 CT Primary

Addresses

Primary practice location

20 York St
New Haven, CT 06510-3220

Mailing address

88 Weber Farm Rd
Norwich, CT 06360-5234
Phone (401) 932-8987

Other practice location 1

88 Weber Farm Rd
Norwich, CT 06360-5234
Phone (401) 932-8987

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
I20230425001017 CT Practitioner - Physician Assistant 8325403439 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
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)

1450 Chapel St B
New Haven, CT 06511-4405
Phone 20386754204405

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

800 Howard Ave
New Haven, CT 06519-1369
Phone (203) 785-2140

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
Physician Assistant

State licenses

LicenseStateTypeSpecialty
6021CTMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Medical Group, Inc. CurrentSince Apr 9, 2023 Accepting new patients
Yale University CurrentSince Jul 1, 2023 Accepting new patients
Yale University CurrentSince Jul 1, 2023 Accepting new patients
Mill Hill Medical Consultants Inc CurrentSince Apr 9, 2023 Accepting new patients

Locations

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

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

20 York St
#2041
North Haven, CT 06510
Phone (203) 688-1734

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

Interoperability endpoints

  • Direct secure messaging: ltetreault610377@direct.ynhh.org

Organizations & group practices 5

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.

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": "1655942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686700800000",
    "number": "1932830585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "88 WEBER FARM RD",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063605234",
            "telephone_number": "401-932-8987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 YORK ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103220",
            "telephone_number": "203-688-4242"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "88 Weber Farm Rd",
            "address_purpose": "LOCATION",
            "city": "Norwich",
            "state": "CT",
            "postal_code": "063605234",
            "country_code": "US",
            "telephone_number": "401-932-8987",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TETREAULT",
        "first_name": "LAURYN",
        "middle_name": "ELIZABETH",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-23",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "6021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.