Individual provider Active NPI

Lauren Bacon, MD

  • Emergency Medicine Physician
  • Farmington, CT
National Provider Identifier
1972065613
Registry record updated Sep 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
72173 Issued in CT
Practice address
263 Farmington Ave
Farmington, CT 06030-6237
Phone
(860) 679-7967
NPI assigned
Apr 2, 2019
Last updated
Sep 26, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 72173 CT Primary

Addresses

Primary practice location

263 Farmington Ave
Farmington, CT 06030-6237

Mailing address

263 Farmington Ave
Farmington, CT 06030-8082
Phone (860) 679-3692

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lbacon56911@direct.med.uchc.edu

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220825000124 CT Practitioner - Emergency Medicine 3375927395 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Howard University College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
State of ConnecticutGroup PAC ID 8022915677, 267 clinicians

Practice addresses (Care Compare)

263 Farmington Ave
Farmington, CT 06030-0001
Phone (860) 679-2000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
State of Connecticut CurrentSince Aug 1, 2022 Accepting new patients
State of Connecticut Emergency Medicine Current Accepting new patients
State of Connecticut CurrentSince Aug 1, 2022 Accepting new patients

Locations

263 Farmington Ave
Farmington, CT 06030
Phone (860) 679-4477

Interoperability endpoints

  • Direct secure messaging: lbacon56911@direct.med.uchc.edu

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, 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": "1554163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664150400000",
    "number": "1972065613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "263 FARMINGTON AVE",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060308082",
            "telephone_number": "860-679-3692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "263 FARMINGTON AVE",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060306237",
            "telephone_number": "860-679-7967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACON",
        "first_name": "LAUREN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-02",
        "last_updated": "2022-09-26",
        "certification_date": "2022-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CT",
            "license": "72173",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lbacon56911@direct.med.uchc.edu",
            "affiliation": "N",
            "address_1": "263 Farmington Ave",
            "city": "Farmington",
            "state": "CT",
            "country_code": "US",
            "postal_code": "060306237",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Farmington, CT

Sources for this page

Verify at the official NPI Registry.