NPIMap

Individual provider Active NPI

Michael James Lacaze, DO

  • Family Medicine Physician
  • Prescott, AZ
National Provider Identifier
1003161035
Registry record updated Feb 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
006806 Issued in AZ
Practice address
1050 Gail Gardner Way Ste 300
Prescott, AZ 86305-1640
Phone
(928) 717-5232
Fax
(928) 717-5238
NPI assigned
Jul 16, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 006806 AZ Primary

Addresses

Primary practice location

1050 Gail Gardner Way Ste 300
Prescott, AZ 86305-1640

Mailing address

PO Box 10880
Prescott, AZ 86304-0880
Phone (602) 406-4786

Other identifiers 3

IdentifierTypeStateIssuer
1003161035MedicaidMI
Z192483MedicaidAZ
006806OtherAZAZ LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160907002775 AZ Practitioner - Family Practice 7113169772 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

7700 E Florentine Rd
Suite 101
Prescott Valley, AZ 86314-2245
Phone (928) 442-8710

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
006806AZMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Yavapai Regional Medical Center Physician Care LLC Family Medicine CurrentSince Sep 1, 2016 Accepting new patients
Yavapai Regional Medical Center Physician Care LLC Current Accepting new patients
Yavapai Regional Medical Center Physician Care LLC CurrentSince Sep 1, 2016 Accepting new patients
Prescott Gastroenterology Past Accepting new patients

Locations

1050 Gail Gardner Way
Ste 300
Prescott, AZ 86305
Phone (928) 717-5232

3120 Clearwater Dr
Prescott, AZ 86305
Phone (928) 445-4818

7700 E Florentine Rd
Ste 101
Prescott Valley, AZ 86314
Phone (928) 442-8710

7700 E Florentine Rd
Bldg B
Prescott Valley, AZ 86314
Phone (928) 442-8117

7880 E Florentine Rd
Prescott Vly, AZ 86314
Phone (928) 772-9977

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.

Hospital & facility affiliations 6

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": "1342396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739750400000",
    "number": "1003161035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10880",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863040880",
            "telephone_number": "602-406-4786",
            "fax_number": "916-636-4358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 GAIL GARDNER WAY STE 300",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863051640",
            "telephone_number": "928-717-5232",
            "fax_number": "928-717-5238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACAZE",
        "first_name": "MICHAEL",
        "middle_name": "JAMES",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-16",
        "last_updated": "2025-02-17",
        "certification_date": "2025-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "006806",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1003161035",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Z192483",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZ LICENSE",
            "identifier": "006806",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott, AZ

Sources for this page

Verify at the official NPI Registry.