Matthew Aaron Lasslo

Primary specialty

CounselorTaxonomy code 101Y00000X

License

LAC-17209 Issued in AZ

Practice address

463 S Lake Powell Blvd
Page, AZ 86040-0856

Phone

(928) 645-5113

Fax

(928) 645-3254

NPI assigned

Aug 7, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Creek Valley Health ClinicGroup PAC ID 0042542706, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/IGHIBD/Endpoint/IGHIBD
• FHIR API: https://fhir4.healow.com/fhir/r4/IGHIBD

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.

• Creek Valley Health Clinic

  • Federally Qualified Health Center (FQHC)
  • Colorado City, AZ
  • NPI 1821652793

  AZ

  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1596758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596758400000",
    "number": "1003426545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 790",
            "city": "PAGE",
            "state": "AZ",
            "postal_code": "860400790",
            "telephone_number": "928-645-5113",
            "fax_number": "928-645-3254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "463 S LAKE POWELL BLVD",
            "city": "PAGE",
            "state": "AZ",
            "postal_code": "860400856",
            "telephone_number": "928-645-5113",
            "fax_number": "928-645-3254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LASSLO",
        "first_name": "MATTHEW",
        "middle_name": "AARON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-07",
        "last_updated": "2020-08-07",
        "certification_date": "2020-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "AZ",
            "license": "LAC-17209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aaron Knudson, D.O.
• Melissa Lynn Kolnik, CRNA
• Lindsey Rae Kozlowski, OTR/L
• Raymond Kwok
• Lake Powell Dental Center, PC
• Elizabeth G. Latham, F.N.P.-C
• Andrew Lewandowski, PHARMD
• Julie A Lindholm, MD
• Christopher Linskey, M.D.
• Mark Longo, RPH

• All providers in Page, AZ
• Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.